Gadolinium-enhanced MR angiography of spinal arteriovenous malformation

Patients with spinal arteriovenous malformation (AVM) have progressive or fluctuating neurological dysfunction because of hemorrhage, venous hypertension, vascular steal phenomenon, or mass effect from venous varicosity. Spinal AVM is classified into four types based on angiographic and operative findings. Conventional diagnostic methods include magnetic resonance imaging (MRI), supine myelogram, and angiogram. MRI can localize the vascular nidus in the cord, but it may sometimes be normal. Spinal angiogram is the definitive diagnostic modality. It is technically demanding and time consuming, requiring catheterization of all spinal vascular pedicles. MR angiography is fast and multiplanar, and it may shorten the duration of catheter angiography by demonstrating the level of feeders. Images of MRI, magnetic resonance angiography (MRA), and catheter angiogram are presented to illustrate the correlation and diagnosis of spinal AVM.