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Cauda Equina Occupation Ratio as a New Imaging Parameter for the Evaluation of Spinal Dural Arteriovenous Fistulae.
- Source :
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World neurosurgery [World Neurosurg] 2019 Oct; Vol. 130, pp. e1020-e1027. Date of Electronic Publication: 2019 Jul 12. - Publication Year :
- 2019
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Abstract
- Background: Because spinal dural arteriovenous fistulae (SDAVF) are rare and their clinical presentation is nonspecific, they are often overlooked during diagnostic evaluations. Typical magnetic resonance imaging (MRI) findings are intramedullary T2-weighted signal hyperintensity and perimedullary flow voids. There are few reports on the characteristic signs of the cauda equina. We assessed the significance of a new imaging parameter, the cauda equina occupation ratio (CEOR), for the evaluation of SDAVF.<br />Methods: We retrospectively analyzed the clinical charts and radiological findings of 20 SDAVF patients treated at our institutions. We evaluated sagittal T2-weighted MRI scans and assessed the CEOR, the occupation ratio of the cauda equina compared to the sagittal diameter of the corresponding lumbar spinal canal. The controls were 21 age- and sex-matched subjects.<br />Results: Of the 20 SDAVF, 10 were at the thoracic and 10 at the lumbar spine. There was no significant difference between the preoperative CEOR and the spinal level of the fistulae or the neurological signs. On preoperative MRI scans, the mean CEOR was 56.0 ± 7.8; postoperatively, it was 37.1 ± 7.4 (P = 0.000). The preoperative CEOR was significantly larger in SDAVF patients than in the controls (P = 0.000); postoperatively, it was smaller than in the controls (P = 0.14).<br />Conclusions: The preoperative CEOR was larger in patients with SDAVF than in the controls. It normalized after successful occlusion of the fistula. Our findings indicate that the CEOR is a useful parameter for the pre- and postoperative evaluation of SDAVF.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Cauda Equina surgery
Central Nervous System Vascular Malformations surgery
Female
Humans
Lumbar Vertebrae surgery
Male
Middle Aged
Preoperative Care methods
Retrospective Studies
Spinal Cord surgery
Thoracic Vertebrae surgery
Cauda Equina diagnostic imaging
Central Nervous System Vascular Malformations diagnostic imaging
Lumbar Vertebrae diagnostic imaging
Spinal Cord diagnostic imaging
Thoracic Vertebrae diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 130
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 31306848
- Full Text :
- https://doi.org/10.1016/j.wneu.2019.07.069