TY - JOUR
T1 - T2-Weighted-Fluid-Attenuated Inversion Recovery Hyperintensity on Magnetic Resonance Imaging Is Associated with Aggressive Symptoms in Patients with Dural Arteriovenous Fistulas
AU - Patel, Bhuvic
AU - Chatterjee, Arindam
AU - Petr, Ondra
AU - Collins, Heather
AU - Lanzino, Giuseppe
AU - Derdeyn, Colin P.
AU - Zipfel, Gregory J.
N1 - Publisher Copyright:
© 2019 American Heart Association, Inc.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Background and Purpose - Several angiographic factors of dural arteriovenous fistulas (dAVFs) are associated with aggressive presentation and poor natural history. We examined the association of magnetic resonance imaging T2-weighted-Fluid-Attenuated Inversion Recovery (T2/FLAIR) hyperintensity with aggressive presentation. Methods - A cohort of dAVF patients from 2 centers was retrospectively examined. T2/FLAIR hyperintensity was determined by blinded, de-identified review and compared with angiographic grade and presenting symptoms. Results - T2/FLAIR hyperintensity was only identified in dAVF patients with cortical venous drainage (CVD). Among patients with CVD, those with T2/FLAIR hyperintensity were more likely to present with aggressive symptoms (20/23, 87.0%) than those without (6/21, 28.5%), P<0.001. All cured dAVFs with symptom resolution and available post-treatment imaging had resolution of T2/FLAIR hyperintensity. Conclusions - T2/FLAIR hyperintensity strongly correlates with aggressive presentation and CVD in dAVF patients, and may identify a subset that would benefit from early treatment.
AB - Background and Purpose - Several angiographic factors of dural arteriovenous fistulas (dAVFs) are associated with aggressive presentation and poor natural history. We examined the association of magnetic resonance imaging T2-weighted-Fluid-Attenuated Inversion Recovery (T2/FLAIR) hyperintensity with aggressive presentation. Methods - A cohort of dAVF patients from 2 centers was retrospectively examined. T2/FLAIR hyperintensity was determined by blinded, de-identified review and compared with angiographic grade and presenting symptoms. Results - T2/FLAIR hyperintensity was only identified in dAVF patients with cortical venous drainage (CVD). Among patients with CVD, those with T2/FLAIR hyperintensity were more likely to present with aggressive symptoms (20/23, 87.0%) than those without (6/21, 28.5%), P<0.001. All cured dAVFs with symptom resolution and available post-treatment imaging had resolution of T2/FLAIR hyperintensity. Conclusions - T2/FLAIR hyperintensity strongly correlates with aggressive presentation and CVD in dAVF patients, and may identify a subset that would benefit from early treatment.
KW - Cerebrovascular disorders
KW - Cohort studies
KW - Humans
KW - Magnetic resonance imaging
KW - Vascular malformations
UR - http://www.scopus.com/inward/record.url?scp=85071711581&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.118.024285
DO - 10.1161/STROKEAHA.118.024285
M3 - Article
C2 - 31409269
AN - SCOPUS:85071711581
SN - 0039-2499
VL - 50
SP - 2565
EP - 2567
JO - Stroke
JF - Stroke
IS - 9
ER -