Department of Neurosurgery, University of California (Davis), Sacramento, USA.
Department of Neurosurgery, Yale University School of Medicine, New Haven, USA.
Interv Neuroradiol. 2021 Aug;27(4):553-557. doi: 10.1177/1591019920988205. Epub 2021 Jan 11.
Intracranial high-resolution vessel wall MRI (VW-MRI) is an imaging paradigm that is useful in site-of-rupture identification in patients presenting with spontaneous subarachnoid hemorrhage and multiple intracranial aneurysms. Only a handful of case reports describe its potential utility in the evaluation of more complex brain vascular malformations. We report for the first time three patients with ruptured cranial dural arteriovenous fistulas (dAVFs) that were evaluated with high-resolution VW-MRI. The presumed site-of-rupture was identified based on contiguity of a venous ectasia with adjacent blood products and thick, concentric wall enhancement. This preliminary experience suggests a role for high-resolution VW-MRI in the evaluation of ruptured cranial dAVFs, in particular, site-of-rupture identification. It also supports an emerging hypothesis that all spontaneously ruptured, macrovascular lesions demonstrate avid vessel wall enhancement.
颅内高分辨率血管壁 MRI（VW-MRI）是一种成像模式，在自发性蛛网膜下腔出血和多发颅内动脉瘤患者中有助于确定破裂部位。只有少数病例报告描述了其在评估更复杂的脑血管畸形中的潜在用途。我们首次报告了 3 例接受高分辨率 VW-MRI 评估的破裂颅 内硬脑膜动静脉瘘（dAVF）患者。根据邻近血液产物的静脉扩张与相邻的连续性，以及厚而同心的壁增强，推测破裂部位。这初步经验表明高分辨率 VW-MRI 在评估破裂的颅 内 dAVF，特别是确定破裂部位方面具有一定作用。它还支持一种新兴假说，即所有自发性破裂的大血管病变均显示出强烈的血管壁增强。
