Measurement of sinus wall thickness and wall enhancement index in dural arteriovenous fistulae by magnetic resonance vessel wall imaging.

BACKGROUND: Dural sinus wall thickness and wall enhancement index (WEI) of dural arteriovenous fistulae (DAVFs) have not been well characterized. This study aimed to measure the sinus wall thickness and WEI by using magnetic resonance vessel wall imaging (MR-VWI).

METHODS: A total 27 DAVF patients and 30 normal healthy individuals were enrolled in this study. All participants were scanned by a 3 T MR scanner with the black blood sequence. The wall thickness and the WEI of the great cerebral vein, the intracranial main dural sinuses with DAVFs, and the contralateral sinuses were measured by two independent neuroradiologists.

RESULTS: The DAVF-affected sinuses had significantly thicker walls (2.277 ± 0.311 mm vs. 1.446 ± 0.188 mm, P < 0.001) and significantly higher WEI (2.253 ± 0.462 vs. 1.173 ± 0.418, P < 0.001) compared to the contralateral ones. They also had significantly thicker walls (2.277 ± 0.311 mm vs. 1.643 ± 0.173 mm, P < 0.001) and significantly higher WEI (2.253 ± 0.462 vs. 1.124 ± 0.254, P < 0.001) compared to the normal controls. Neither the sinus wall thickness (r = -0.317, P = 0.107) nor the WEI (r = 0.019, P = 0.923) was significantly correlated with the Cognard types in DAVF patients. The WEI of the DAVF draining vein was significantly higher compared to the static venous wall (1.972 ± 0.629 vs. 0.532 ± 0.243, P < 0.001).

CONCLUSION: T1-CUBE MRI is useful in measuring sinus all thickness and WEI of DAVFs, providing a new method for diagnosing this disease.