title: Type 1 perimedullary arteriovenous fistula with subarachnoid hemorrhage: utility of contrast-enhanced 3D gradient-echo technique.
abstract: OBJECTIVE
  In patients with perimedullary arteriovenous fistula (AVF) with subarachnoid hemorrhage (SAH), knowledge of lesion location is necessary to select the appropriate approach for catheter spinal angiography. We evaluated the utility of 3-dimensional (3D) fast imaging with steady-state precession (FISP) sequence for detecting type 1 perimedullary AVF with SAH.
  
  
  METHODS
  We evaluated 4 patients (2 men, 2 women, aged 53 to 68 years, mean age, 59.25 years) with type 1 perimedullary AVF who presented with SAH and underwent conventional spin-echo MR and contrast-enhanced 3D FISP imaging. Two neuroradiologists assessed detection of vascular lesions and delineation of their relationships to the adjacent vessels. Catheter angiography was used as the reference standard and compared with the MR findings.
  
  
  RESULTS
  Perimedullary AVF was located at the medullocervical junction in 2 patients, cervical spine in one, and thoracic spine in one. For all patients, use of contrast-enhanced 3D FISP in addition to conventional MR imaging improved lesion detection and delineation of the relationship between the lesion and surrounding vessels.
  
  
  CONCLUSIONS
  Contrast-enhanced 3D FISP imaging was useful for detecting and delineating type 1 perimedullary AVF with SAH.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Masuma
authors.initials: M
authors.lastname: Akter
authors.forename: Toshinori
authors.initials: T
authors.lastname: Hirai
authors.forename: Mika
authors.initials: M
authors.lastname: Kitajima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kai
authors.forename: Motohiro
authors.initials: M
authors.lastname: Morioka
authors.forename: Akira
authors.initials: A
authors.lastname: Sasao
authors.forename: Daisuke
authors.initials: D
authors.lastname: Utsunomiya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uetani
authors.forename: Yukunori
authors.initials: Y
authors.lastname: Korogi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D000792:Angiography; D001164:Arteriovenous Fistula / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013131:Spine / Q000098:blood supply*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis*
chemical_list: D003287:Contrast Media