Demographics:
65 years old, Male
Indication:
Bilateral leg weakness
Findings
- Extensive central cord T2/STIR hyperintensity, enhancement, and mild cord expansion extending from T6-T7 through the conus
- Curvilinear areas of flow-related signal loss along the dorsal surface of the mid and lower thoracic spinal cord
- Mild multilevel disc space narrowing and facet hypertrophy without significant spinal canal or neural foraminal stenosis
- Multilevel anterior osteophytosis in the mid and lower thoracic spine
- Conus terminates in normal position
- Normal marrow signal
- Normal alignment
Diagnosis
Spinal dural arteriovenous fistula
Sample Report
Extensive central cord T2/STIR hyperintensity, enhancement, and mild cord expansion extending from T6-T7 through the conus with suspected prominent vessels along the dorsal surface of the mid and lower thoracic spinal cord. These findings are most concerning for the presence of a spinal dural AV fistula. Less likely differential considerations include demyelinating disease or other infectious/inflammatory myelitis. Recommend catheter angiography for further evaluation.
Discussion