AI Article Synopsis
- The study investigates how T2-weighted Fluid-Attenuated Inversion Recovery (T2/FLAIR) hyperintensity on MRI relates to the aggressive presentation of dural arteriovenous fistulas (dAVFs).
- A retrospective analysis of dAVF patients revealed that T2/FLAIR hyperintensity is only present in those with cortical venous drainage (CVD), and those patients are more likely to show severe symptoms.
- The findings suggest that T2/FLAIR hyperintensity could be a key indicator of aggressive dAVF cases, potentially guiding earlier treatment decisions.
Article 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.
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| http://dx.doi.org/10.1161/STROKEAHA.118.024285 | DOI Listing |
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