关键词: 动静脉瘘; 磁共振成像; 血管造影术; 数字减影

Abstract: Objective To investigate the clinical and image feature of the spinal dural arteriovenous fistula (SDAVF) and to deepen the understanding of the disease.Methods Detailed clinical and image examinations were performed in all the 6 patients, who underwent spinal magnetic resonance imaging (MRI), selective spinal digital subtraction angiography (DSA). They all fulfilled the diagnostic criteria for the spinal dural arteriovenous fistula. Some of them accepted the therapy of embolism.Results Mean age was 49.3 years (27-65 years) and 5 were men. The spinal lesions were located in the segment of thorax and lumbar. Initial weakness and sensory changes were usually asymmetric (5 patients) and ascend from the lower extremities. Initial symptoms included leg sensory disturbances (3 patients), pain involving hip and legs (2 patients), leg weakness (2 patients). Sphincter disturbances were presented in all of the 6 patients. Five patients presented subacute or chronic period. Symptoms fluctuated in 4 of 6 patients. Spinal MRI showed the swelling and the abnormal signal in the spinal cord lesion. Persistent pathological vessels can be seen on MRI and be helpful for the diagnosis. DSA is the gold diagnostic standard for the disease when the dural arteriovenous fistula and arterialized draining vein are found. The sign level was not correlated with the image level in the all cases. Four of 6 patients accepted therapy of embolism, 1 patient failed to improve and 3 patients demonstrated delayed deterioration after a period of improvement due to recurrentfistulas.Conclusion SDAVF had its clinical and image features. Neuroimaging was useful in confirming the diagnosis. Thus, the spinal should be examined with MRI when a SDAVF is suspected. The therapy of embolism was relatively effective.

Key words: Arteriovenous fistula; Magnetic resonance imaging; Angiography; digital subtraction