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Arterialization of Cerebral Veins on Dynamic MDCT Angiography: A Possible Sign of a Dural Arteriovenous Fistula

Stephan Meckel1, Karl-Olof Lovblad2, German Abdo2, Diego San Millan Ruiz2, Jacqueline Delavelle2, Ernst-Wilhelm Radue1, Daniel A. Ruefenacht2 and Stephan G. Wetzel1

1 Division of Neuroradiology, Department of Radiology, University Hospital Basel, Petersgraben 4, Basel CH-4031, Switzerland.
2 Division of Neuroradiology, Department of Radiology, University Hospital Geneva, Geneva, Switzerland.



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Fig. 1A. 70-year-old man with type 2b dural arteriovenous fistula in left sigmoid sinus. Axial CT angiographic (CTA) image shows high-intensity filling in left sigmoid sinus (white arrow); note adjacent pacchionian granulation. Contrast intensity is same as that of basilar artery (black arrow). Contralateral sinus structures show less intense contrast intensity (arrowhead).

 


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Fig. 1B. 70-year-old man with type 2b dural arteriovenous fistula in left sigmoid sinus. Axial CTA image obtained at level of cavernous portion of internal carotid artery shows arterial contrast intensity within left vein of Labbé (arrow) caused by backflow from fistula. Superior sagittal sinus shows lower venous intensity (arrowhead).

 


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Fig. 1C. 70-year-old man with type 2b dural arteriovenous fistula in left sigmoid sinus. Cerebral angiogram with external carotid artery injection and mask subtraction clearly shows arterial feeders from occipital artery and reflux into vein of Labbé.

 


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Fig. 2. 77-year-old woman with type 2b dural arteriovenous fistula at junction of left transverse and sigmoid sinuses. Reconstructed coronal CT angiographic image of posterior fossa obtained at level of foramen magnum shows filling of left transverse sinus with high-contrast arterialized blood. Right transverse sinus shows less intense venous contrast filling.

 

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