Computed tomography (CT) angiography with multidetector row helical CT for detecting spinal dural arteriovenous fistula

• Published in: Rinsho Shinkeigaku Vol. 48; no. 3; pp. 205 - 207
• Main Authors: Kobessho, Hiroshi, Mitsui, Shigeru, Ishihara, Hiroyuki, Fujii, Masahiko, Kawasaki, Ryota, Tachibana, Shigekuni, Kanda, Fumio
• Format: Journal Article
• Language: Japanese
• Published: Japan Societas Neurologica Japonica 01.03.2008
• Subjects: Angiography - methods; Central Nervous System Vascular Malformations - diagnostic imaging; Central Nervous System Vascular Malformations - surgery; CT angiography (CTA); Humans; Iliac Artery - diagnostic imaging; lateral sacral artery; Male; Middle Aged; multidetector row computed tomography (MDCT); Sacrococcygeal Region - blood supply; Spinal Cord - blood supply; spinal dural arteriovenous fistula; Tomography, Spiral Computed - methods; Treatment Outcome
• ISSN: 0009-918X; 1882-0654
• DOI: 10.5692/clinicalneurol.48.205

A 59-year-old man had have dysuria and left thigh pain for 2 months. He also experienced transient weakness of both legs twice, which recovered within a few hours. One month ago, he had bowel disturbance. Lumbar MRI showed a swelling of the conus medullaris. Enlarged and tortuous vessels behind the spinal cord on lumbar MRA and CT myelography was demonstrated. Though angiogram through intercostal and lumbar arteries revealed no abnormal findings, CT angiography with multidetector row helical CT (MDCT) showed abnormal vessel in intradural space at sacral level. Angiogram through left internal iliac artery revealed abnormal vessel fed by branches of the lateral sacral artery at the early arterial phase. Thus, diagnosis of dural arteriovenous fistula (DAVF) at the left S1 level was confirmed. It was indicated that CT angiography with MDCT was useful in detecting spinal DAVF especially at sacral level.