Additive Value of 3T 3D CISS Imaging to Conventional MRI for Assessing the Abnormal Vessels of Spinal Dural Arteriovenous Fistulae

  • Uetani Hiroyuki
    Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
  • Hirai Toshinori
    Department of Radiology, Faculty of Medicine, Miyazaki University
  • Kitajima Mika
    Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
  • Azuma Minako
    Department of Radiology, Faculty of Medicine, Miyazaki University
  • Yano Shigetoshi
    Department of Diagnostic Neurosurgery, Graduate School of Medical Sciences, Kumamoto University
  • Nakamura Hideo
    Department of Diagnostic Neurosurgery, Graduate School of Medical Sciences, Kumamoto University
  • Makino Keishi
    Department of Diagnostic Neurosurgery, Graduate School of Medical Sciences, Kumamoto University
  • Kai Yutaka
    Department of Neurosurgery, Aso Central Hospital
  • Nagayama Yasunori
    Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University
  • Kadota Yoshihito
    Department of Radiology, Faculty of Medicine, Miyazaki University
  • Yamashita Yasuyuki
    Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University

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Abstract

<p>Introduction: We investigated the additive value of the 3T 3D constructive interference in steady state (CISS) sequence to conventional MRI for the evaluation of spinal dural arteriovenous fistulae (SDAVF).</p><p>Materials and Methods: We included 16 consecutive patients (15 men, 1 woman; age range 42–81 years; mean 64 years) with SDAVF who underwent 3T MRI and digital subtraction angiography (DSA) before treatment. Two neuroradiologists independently evaluated the presence of abnormal vessels on 3D CISS-, T2- and T1-weighted images (T1WI, T2WI), and contrast-enhanced T1WI using a 3-point grading system. Interobserver agreement was assessed by calculating the κ coefficient.</p><p>Results: The SDAVF site was the cervical region in one patient, the thoracic region in 12 patients, the lumbar region in two, and the sacral region in one. For the visualization of abnormal vessels, the mean score was significantly higher for 3D CISS than the other sequences (P < 0.05). In 12 of 16 cases (75%) both readers made definite positive findings on additional 3D-CISS images. Interobserver agreement was excellent for 3D CISS images (κ = 1.0), good for T1WI (κ = 0.78; 95% confidence interval [CI] 0.54–1.00) and T2WI (κ = 0.74; 95% CI 0.48–1.00) and moderate for contrast-enhanced T1WI (CET1WI) (κ = 0.50; 95% CI 0.21–0.80).</p><p>Conclusion: For the assessment of abnormal vessels of SDAVF, the 3T 3D CISS sequence adds value to conventional MRI.</p>

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