Preangiographic evaluation of spinal dural arteriovenous fistulas with elliptic centric contrast-enhanced MR Angiography and effect on radiation dose and volume of iodinated contrast material.
Preangiographic evaluation of spinal dural arteriovenous fistulas with elliptic centric contrast-enhanced MR Angiography and effect on radiation dose and volume of iodinated contrast material.
复制标题
DOI：
--
复制
发表时间：
2005-04
期刊：
影响因子：
--
通讯作者：
P. Luetmer;J. Lane;J. Gilbertson;M. Bernstein;J. Huston;J. Atkinson
中科院分区：
文献类型：
--
作者：
P. Luetmer;J. Lane;J. Gilbertson;M. Bernstein;J. Huston;J. Atkinson
背景与目的脊髓硬膜动静脉瘘（AVFs）的检测和定位仍然是诊断上的挑战。本研究验证了椭圆中心磁共振增强血管造影（MRA）可用于检测脊髓硬膜avf，预测瘘的水平，并减少常规血管造影相关的碘化造影剂的辐射剂量和体积的假设。方法对2000年12月至2004年3月间31例疑似硬脊膜AVF的患者进行分析。所有患者均行MRA和常规血管造影。通过分析全透视时间和碘化造影剂使用体积来评估MRA对后续常规血管造影的影响。结果：在血管造影中，31例患者中有22例被诊断为脊髓硬膜AVF， MRA显示22例患者中有20例出现AVF。MRA结果正确预测了9例中的7例血管造影阴性。在20例真阳性的MRA结果中，14例的瘘管水平被包括在成像体积中。在这14例中，有13例的MRA结果正确地预测了瘘的侧面和水平到一个椎体水平。在MRA显示正确水平的13例脊髓硬膜AVF患者中，透视时间和造影剂体积减少了50%以上。结论增强mri可用于检测硬脊膜avf，预测瘘的水平，大大减少导管脊髓血管造影相关造影剂的辐射剂量和体积。
BACKGROUND AND PURPOSE The detection and localization of spinal dural arteriovenous fistulas (AVFs) remain diagnostic challenges. This study tested the hypothesis that elliptic centric contrast-enhanced MR angiography (MRA) can be used to detect spinal dural AVFs, predict the level of fistulas, and reduce the radiation dose and volume of iodinated contrast material associated with conventional angiography. METHODS We examined 31 patients who presented with suspected spinal dural AVF between December 2000 and March 2004. All patients underwent MRA and conventional angiography. The effect of MRA on subsequent conventional angiography was assessed by analyzing total fluoroscopy time and volume of iodinated contrast material used. RESULTS At angiography, spinal dural AVFs were diagnosed in 22 of 31 patients, and MRA depicted an AVF in 20 of the 22 patients. MRA findings correctly predicted a negative angiogram in seven of nine cases. Of the 20 true-positive MRA results, the level of the fistula was included in the imaging volume in 14. In 13 of these 14 cases, MRA results correctly predicted the side and the level of the fistula to within one vertebral level. Fluoroscopy time and the volume of contrast agent was reduced by more than 50% in the 13 patients with a spinal dural AVF in whom MRA prospectively indicated the correct level. CONCLUSION Contrast-enhanced MRA can be used to detect spinal dural AVFs, predict the level of fistulas, and substantially reduce the radiation dose and volume of contrast agent associated with catheter spinal angiography.