Article Figures & Data
Figures
- Fig 1.
Case 19. A 78-year-old woman with dAVF in the left CS.
A, Lateral intra-arterial DSA of the left ECA shows the arteriovenous shunt in the left CS (long arrow) and retrograde venous drainage to the superior ophthalmic vein (short arrow) and cerebral cortical veins (arrowheads). Severity of the drainage was grade 2 (26%–50% of cortical veins on angiography).
B, Axial T2-weighted SE MR image shows flow voids (arrows) in the subarachnoid space, suggesting dilated cortical veins in bilateral frontal and parietal lobes.
C, Abnormal dilated cortical veins (arrows) are more prominent on this axial enhanced T1-weighted SE image than in B.
- Fig 2.
Case 13. A 70-year-old woman with dAVF in the left CS. Enhanced 3D MP-RAGE image clearly shows marked dilatation and thrombus in the anterior part of the left superior ophthalmic vein (arrows).
- Fig 3.
Case 17. A 50-year-old woman with dAVF in the left transverse sinus.
A, Lateral intra-arterial DSA of the left ECA shows obstruction of the left transverse sinus (arrows). Abnormal vessels (arrowheads) are observed around the obstructed left transverse sinus. Severity of the drainage was grade 2 (26%–50% of cortical veins on angiography).
B, Enhanced 3D MP-RAGE image shows abnormal dilated veins at the base of the cerebrum (arrow) and in the posterior fossa (arrowhead). Bilateral posterior cerebral arteries were identified on other sections (not shown).
- Fig 4.
Case 4. A 62-year-old woman with dAVF in the left CS.
A, Lateral intra-arterial DSA of the left ICA shows retrograde venous drainage to the superior ophthalmic (arrow) and pontomedullary (arrowheads) veins.
B, Enhanced 3D MP RAGE image shows cephalocaudal, contiguous enhancing structures (arrow) at the ventral side of midbrain corresponding to retrograde venous drainage to the pontomedullary vein.
- Fig 5.
Case 3. A 58-year-old woman with dAVF in the bilateral CSs. Enhanced 3D MP-RAGE image (and 3D FISP image, not shown) depicts a filling defect in the right inferior petrosal sinus (arrow). This finding suggests thrombosis in the right inferior petrosal sinus.
Tables
Patient/Age (years)/Sex Fistula Site Feeding Artery Obstructed Petrosal Sinus Retrograde Drainage Veins 1/69/F R/L CS R/L ECA, ICA R/L superior, inferior Cortical, deep 2/66/F R/L CS R/L ECA, ICA R/L superior, inferior Cortical, deep 3/58/F R/L CS R/L ECA, ICA R/L superior, inferior Cortical, deep, superior ophthalmic, PF 4/62/F L CS R/L ECA, ICA L superior, R/L inferior Deep, superior ophthalmic, PF, SV 5/77/M L CS R/L ICA R/L superior, inferior Cortical, deep 6/51/F R CS R/L ECA, ICA R/L superior, inferior Superior ophthalmic 7/62/F R CS R/L ECA, ICA R/L superior, inferior Deep, superior ophthalmic 8/62/F L CS R/L ECA, ICA R/L superior, inferior Superior ophthalmic 9/76/F R/L CS R ICA, R/L ECA R/L superior, inferior Cortical, deep, superior ophthalmic, PF 10.52/M R CS R/L ECA Not applicable Cortical 11/50/F L CS L ECA Not applicable Superior ophthalmic 12/52/F L CS L ECA R/L superior, inferior Deep 13/70/F L CS L ECA, ICA R/L superior, inferior Superior ophthalmic 14/77/F L CS L ECA, ICA L superior, R/L inferior Cortical, deep 15/70/M Tent L ECA, ICA; R/L VA a Cortical, deep 16/64/M L CS L ECA, ICA R/L superior, inferior PF 17/50/F L transverse sinus L ECA, ICA; L a Cortical, deep, PF, SV, superior ophthalmic 18/70/F L CS R ECA, ICA Not applicable Superior ophthalmic, PF 19/78/F L CS R/L ECA, R, ICA L inferior Cortical, superior ophthalmic, SV 20/70/M L sigmoid sinus L ECA a Cortical, PF 21/71/F R CS R ECA, ICA L inferior Superior ophthalmic Note.—PF, leptomeningeal vein of the posterior fossa; SV, spinal vein; VA, verbetral arteries.
a Obstruction was in the L sigmoid sinus and superior sagittal sinus (patient 15), R transverse sinus (patient 17), or R transverse sinus (patient 20).
Veina Sensitivity(%) Specificity(%) Accuracy(%) Cortical T1 weighted 50 100 73.8 T2 weighted 77.3 100 88.1 CE T1 weighted 100 100 100 3D FISP 77.3 86.7 85.7 3D CE MP-RAGE 100 90 95.3 Ophthalmic T1 weighted 91.7 100 95.2 T2 weighted 66.7 94.5 78.6 CE T1 weighted 40.0 100 68.5 3D FISP 45.9 100 69.1 3D CE MP-RAGE 91.7 83.4 88.1 Deep T1 weighted 13.4 100 54.8 T2 weighted 47.3 100 69.1 CE T1 weighted 34.7 95.0 68.4 3D FISP 46.8 95.5 69.1 3D CE MP-RAGE 51.4 85.0 69.1 Posterior T1 weighted 25.9 100 73.8 T2 weighted 25.9 100 73.8 CE T1 weighted 50.0 96.5 81.6 3D FISP 18.8 96.5 69.1 3D CE MP-RAGE 59.0 82.3 76.2 Spinal T1 weighted 0 100 85.7 T2 weighted 16.7 100 85.7 CE T1 weighted 75.0 100 94.8 3D FISP 0 100 85.7 3D CE MP-RAGE 100 100 100 a CE = contrast enhanced.
