Prognostic value of magnetic resonance imaging in spinal dural arteriovenous fistulas.

Abstract

To investigate the effect of pre- and postoperative magnetic resonance imaging (MRI) findings on the prognosis of patients with spinal dural arteriovenous fistulas (SDAVFs) treated surgically. A total of 76 patients from Jan 1, 2013, to June 30, 2020, were enrolled in this study. Their spinal neurological function was evaluated and graded by the modified Aminoff-Logue Scale (mALS). Preoperative and 3months postoperative MRI results were evaluated, and their relationship with patients' pre- and postoperative spinal neurological function at 1year after surgery was calculated. Analysis of variance (ANOVA), the chi-square test, and others were used to investigate the prognostic value of MRI for patients with SDAVFs treated surgically. According to our results, the extent of spinal edema on preoperative MRI was significantly correlated with the patients' degrees of preoperative spinal neurological dysfunction. The severity of preoperative spinal neurological dysfunction was significantly greater in patients whose extent of spinal edema was identified at ≥ 5 vertebral levels. Importantly, patients with a reduction in the degree of spinal edema ≥ 50% on 3-month postoperative MRI demonstrated significant improvement in spinal neurological function 1year after surgery. In patients with SDAVFs, the extent of spinal edema on preoperative MRI may predict the severity of preoperative spinal neurological dysfunction. There was a significant correlation between the degree of reduction in spinal edema at 3months after operation and patients' clinical outcomes 1year after surgery.