Fig. 1

MRI characterization of SDAVF. Sagittal (A) and axial (B) T2-weighted images of the thoracic spine on day 3 reveals longitudinally extensive centromedullary T2 hyperintensity extending from T8 through the conus (A, arrowheads). Axial T1 post contrast image (C) at L2 shows diffuse abnormal thickening and hyperenhancement of the cauda equina nerve roots. Follow-up MRI total spine on day 32, which included high resolution sagittal 3D T2-SPACE sequence (D), clearly depicts numerous dilated vascular flow voids along the dorsal spinal cord surface (D, arrowheads). These abnormal vessels are not well resolved with the conventional T2 sequence (E) acquired as part of the same exam and registered to the same level of the thoracic spine shown in panel D. 3D volume-rendered reformatted image (F) from conventional digital subtraction angiogram reveals right T10 shunting AVF (arrowhead) with multiple dilated pial vessels extending craniocaudally along the spinal canal (F, arrows), confirming diagnosis of SDAVF