Fig 2.

SDAVF in a 69-year-old male patient visualized by MRA and DSA. Demonstration of a normal spinal cord supplying artery and arterialized veins of a SDAVF supplied from the same segmental artery.

A, The sagittal T2-weighted image reveals a signal intensity increase of the thoracolumbar cord and some flow voids at the dorsal aspect of the spinal cord raising the suspicion of a vascular spinal cord abnormality (small white arrows).

B, Sagittal MIP of the MRA examination showing the overview and localization of the dilated veins (small black arrows).

C, The coronal target MRA MIP demonstrates the feeding segmental artery of the SDAVF at the first lumbar level (L1; gray arrow).

D, The localization of this origin is confirmed by DSA. In addition to the fistula with dilated veins (small black arrows), DSA shows an anterior spinal cord supplying artery (white arrow) originating from the same segmental vessel.

E, On the targeted MPR image of the MRA examination, the anterior radiculomedullary artery could be visualized retrospectively (white arrow) and localized at the first lumbar level (L1). Please note that the normal spinal cord supplying artery, which is not involved in the AV-shunt, is very thin on both the DSA and MRA image.

F, This anterior spinal artery (white arrow) is also demonstrated on the oblique sagittal target MRA MIP and can be separated from the abnormal veins of the SDAVF lying posteriorly (small black arrows).

The corresponding DSA projections of the early (G) and late phase (H) for comparison.