T2-Weighted-Fluid-Attenuated Inversion Recovery Hyperintensity on Magnetic Resonance Imaging Is Associated with Aggressive Symptoms in Patients with Dural Arteriovenous Fistulas

Bhuvic Patel, Arindam Chatterjee, Ondra Petr, Heather Collins, Giuseppe Lanzino, Colin P. Derdeyn, Gregory J. Zipfel

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)2565-2567
Number of pages3
JournalStroke
Volume50
Issue number9
DOIs
StatePublished - Sep 1 2019

Keywords

  • Cerebrovascular disorders
  • Cohort studies
  • Humans
  • Magnetic resonance imaging
  • Vascular malformations

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