Two Cases of Dural Arteriovenous Fistula Treated with Transvenous Embolization Performed by Evaluating the Occluded Sinus with MRI of Various Sequences

Abstract

Objective: In transvenous embolization of dural arteriovenous fistula, there is a risk of perforation when passing through the occluded sinus. We report two cases in which preoperative evaluation of the occluded venous sinus was performed using MRI of various sequences and treatment was successful.

Case Presentation: Both cases were dural arteriovenous fistulas with isolated sinus from the left transverse sinus to the sigmoid sinus. Phase-contrast MRA (PC MRA) showed no depiction in either the left transverse sinus or the sigmoid sinus, but contralateral approach was possible because a depiction of the occluded left transverse sinus was observed by contrast 3D variable refocusing flip angle turbo spin-echo (3D VRFA TSE) T1 and contrast 3D gradient echo (3D GRE) T1.

Conclusion: It was possible to evaluate the venous sinus by combining MRI of various sequences and to take a safe approach to isolated sinus.