To illustrate the imaging spectrum of Spinal Arteriovenous Malformations. Review imaging anatomy of feeding arteries, draining veins, and nidus (when present); localize AV shunts in relation to the spinal cord, dura, and paraspinal tissues. Distinguish different types of AV shunts including Type I, dural AV fistulas (AVF); Type II, intramedullary glomus AV malformations (AVM); Type III, juvenile AVMs; and Type IV, intradural perimedullary AVFs. Key differential diagnosis, clinical presentations and diagnostic pitfalls to avoid.

Spinal arteriovenous (AV) shunts/malformations are rare (3-4% space occupying spinal lesions) complex vascular lesions for which multiple classification schemes have been proposed. The most widely adopted scheme in the literature consists of four types: Type I, dural AV fistulas (AVF); Type II, intramedullary glomus AV malformations (AVM); Type III, juvenile AVMs; and Type IV, intradural perimedullary AVFs. Magnetic resonance imaging (MRI) and angiography (MRA) techniques permit detailed assessment of spinal AV shunts, although digital subtraction angiography (DSA) is the gold standard for delineating vascular anatomy...

Spinal vascular anatomy: Arterial supply: The intrinsic arterial supply to the central spinal cord is provided by branches of sulcal arteries which enter the cord substance via the central median fissure. The cord periphery is supplied by radial perforating branches of the pial arterial surface network sometimes referred to as the vasocorona1. These intrinsic arteries are fed by three longitudinally-oriented arteries including the anterior spinal artery (ASA) coursing along the anterior median sulcus and paired posterior spinal arteries (PSA). The anterior and posterior spinal arteries...

The relatively infrequent and anatomically complex nature of spinal arteriovenous fistulas and malformations can present a diagnostic challenge to the interpreting radiologist. Assessment of these lesions can be further complicated by the lack of a universally accepted classification scheme. However, a strong understanding of spinal vascular anatomy, along with a working knowledge of the four most frequently described types of spinal AV malformation, permits a useful initial evaluation of these lesions.

M. P. Kona; Worcester, MA/US - nothing to disclose S. Rohatgi; Worcester, MA/US - nothing to disclose

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