title: Value of prominent flow voids without cord edema in the detection of spinal arteriovenous fistulae.
abstract: OBJECTIVE
  To determine the prevalence of spinal dural arteriovenous fistulae (SDAVF) in patients presenting with prominent vascular flow voids on imaging without other imaging findings suggestive of SDAVF.
  
  
  METHODS
  We retrospectively identified patients from January 1, 2005 to March 1, 2012 who underwent spinal angiography for suspected SDAVF with prominent vascular flow voids on prior imaging. We excluded patients with other major spinal pathology or other imaging findings of SDAVF including cord hyperintensity, enhancement, or expansion. We calculated the proportion of patients with positive findings for SDAVF on angiography and evaluated the prevalence of SDAVF for this finding alone and in correlation with clinical findings.
  
  
  RESULTS
  18 patients underwent spinal angiography for prominent flow voids on imaging without other spinal pathology or imaging findings of SDAVF. Three had a SDAVF detected on angiography. The prevalence of SDAVF in this population was low, only 17% (95% CI 6-39%). All of the patients with positive angiography findings had myelopathy, increasing the prevalence to 100% if the additional clinical finding of myelopathy was present.
  
  
  CONCLUSIONS
  Prominent flow voids without other imaging findings suggestive of SDAVF is poorly predictive of the presence of a SDAVF, unless myelopathy is present clinically.
authors.affiliation: Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Lea M
authors.initials: LM
authors.lastname: Alhilali
authors.affiliation: Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Arich R
authors.initials: AR
authors.lastname: Reynolds
authors.affiliation: Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Saeed
authors.initials: S
authors.lastname: Fakhran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001164:Arteriovenous Fistula / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D057446:Hydrodynamics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult