Terwey B, Becker H, Thron A K, Vahldiek G
Radiological Institute, Oldenburg, F.R.G.
J Comput Assist Tomogr. 1989 Jan-Feb;13(1):30-7. doi: 10.1097/00004728-198901000-00006.
To evaluate the role of magnetic resonance (MR) in the diagnosis of dural arteriovenous (AV) fistulas and the resulting myelopathy, the MR examinations of 11 patients with symptoms and signs of slowly progressive myelopathy of the lower spinal cord have been reviewed. Patients with intradural or extradural AV malformations were excluded. Six patients have been examined without the use of a contrast agent. The other five patients were studied prior and after intravenous administration of gadolinium-diethylenetriamine pentaacetic acid (DTPA). Serpentine linear areas of low signal due to flow void effects within the subdural space have been detected in seven patients. The T1-weighted sagittal images and T2-weighted sagittal and axial images demonstrated signal intensity changes within the center of the cord due to prolongation of T1 and T2 relaxation times. In addition, a relatively abrupt increase of the sagittal and transverse diameters of the lower thoracic cord was found in all cases. In nine patients T1-weighted, proton-density and T2-weighted sagittal images presented "blurred" margins of the lower thoracic cord. After intravenous administration of Gd-DTPA (0.1 mmol/kg), contrast enhancement was present not only within these vessels but also within the lower spinal cord. There was only slight enhancement of the cord immediately after injection of the contrast agent, but significant enhancement was observed 40-45 min later.
为评估磁共振（MR）在诊断硬脑膜动静脉（AV）瘘及其所致脊髓病中的作用，回顾了11例有下脊髓缓慢进展性脊髓病症状和体征患者的MR检查结果。排除硬膜内或硬膜外AV畸形患者。6例患者未使用造影剂进行检查。另外5例患者在静脉注射钆-二乙烯三胺五乙酸（DTPA）前后进行了研究。7例患者在硬膜下间隙内检测到因血流空效应导致的蜿蜒状低信号线性区域。T1加权矢状位图像以及T2加权矢状位和轴位图像显示，由于T1和T2弛豫时间延长，脊髓中心信号强度发生变化。此外，所有病例均发现下胸段脊髓矢状径和横径相对突然增大。9例患者的T1加权、质子密度和T2加权矢状位图像显示下胸段脊髓边缘“模糊”。静脉注射钆喷酸葡胺（0.1 mmol/kg）后，不仅这些血管内有造影剂增强，下脊髓内也有增强。注射造影剂后立即脊髓仅有轻微增强，但在40 - 45分钟后观察到明显增强。
