Fig 5.

Images in a 62-year-old man with a 19-month history of progressive lower-extremity motor and sensory dysfunction and neurogenic bladder diagnosed elsewhere, with transverse myelitis. Far left and middle left, MRA performed with a bolus of gadolinium-based contrast agent and thin, 6-mm coronal MIP images obtained at 2-mm increments through the spinal canal. Far left, Image shows a prominent medullary vein at the level of the left T11 foramen (arrow). Middle left, Image shows that the medullary vein is continuous with a prominent medullary vein emanating from the left T12 foramen (arrow). Far right and middle right, Limited catheter, 4- and 10-second spinal angiograms confirm a spinal dural AVF located under the left T12 pedicle (curved arrow). Left T12 medullary vein loops back toward the left T11 foramen (straight arrow). The 10-second delayed image shows opacification of the dilated coronal venous plexus. MRA allowed us to limit angiography to the bilateral T11-L1 segmental arteries and thus limit the cost, radiation exposure, and dose of contrast agent (to 57 mL).