Preoperative evaluation of spinal vascular malformation by MR angiography: how reliable is the technique: case report and review of literature.
Contrast-enhanced MR angiography (MRA) has been increasingly used in the evaluation of spinal vascular malformations. Even though MR spinal angiography has several advantages over catheter spinal angiography (DSA), however, spinal DSA must never be omitted before operation, even if the vascular malformation is nicely demonstrated by MR angiography. We report a case of spinal vascular malformation in which MR angiography provided great images which almost convinced everyone about the type and site of malformation/fistula. The images were so convincing that it was almost decided to skip catheter based angiography, citing reason of disadvantages of catheter based angiography over MR angiography. However, spinal DSA was luckily done which completely changed the type and site of malformation and helped in avoiding failed surgery. We conclude that even though catheter based spinal angiography has disadvantages over MRA, it should never be omitted from the diagnostic protocol.
Sharma
Ashwani Kumar
AK
Division of Neuroradiology, Department of Radiology, Strong Memorial Hospital, URMC, 601 Elmwood Avenue, Rochester, NY 14620, USA. aksharma73@rediffmail.com
Westesson
Per-Lennart
PL
D000328:Adult; D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D020785:Central Nervous System Vascular Malformations / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D018810:Magnetic Resonance Angiography; D011300:Preoperative Care / Q000379:methods; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000098:blood supply*; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000002:abnormalities*