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Issue: Vol. 563 No. 2 (2026)
Section: Các bài báo
DOI: 10.51298/vmj.v563i2.18966
Date Published: 05/10/2026
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How to Cite
Võ, P. T., Phan, C. C., Trần, Q. T., Hà, T. B. T., & Bùi, T. S. H. (2026). ROLES OF SWI IN EVALUATING OF DURAL ARTERIOVENOUS FISTULAS WITH CORTICAL VENOUS DRAINAGE. Vietnam Medical Journal, 563(2). https://doi.org/10.51298/vmj.v563i2.18966

ROLES OF SWI IN EVALUATING OF DURAL ARTERIOVENOUS FISTULAS WITH CORTICAL VENOUS DRAINAGE

Phương Trúc Võ1, , Công Chiến Phan1, Quốc Tuấn Trần2, Thị Bích Trâm Hà1, Thị Song Hạnh Bùi1
1 Bệnh viện Đại học Y dược TP.HCM
2 Đại học Y dược TP.HCM

Main Article Content

Abstract

Objective: To evaluate the role of susceptibility-weighted imaging (SWI) in the diagnosis of dural arteriovenous fistulas (dAVFs) and the assessment of venous reflux.


Subjects and Methods: A retrospective study was conducted from January 2020 to January 2025, including 97 patients (28 males, 69 females; age range 17–89 years, mean age 60 years) with dAVFs confirmed on digital subtraction angiography (DSA). Conventional brain MRI studies were reviewed to assess the diagnostic value of SWI sequences in detecting venous reflux.


Results: Among 65 cases of cavernous sinus dAVFs, hyperintensity within the cavernous sinus on magnitude SWI images was identified in 9 cases (13.8%). For evaluation of ophthalmic venous drainage in cavernous sinus dAVFs, the hyperintense signal of the superior ophthalmic vein on magnitude SWI demonstrated a sensitivity of 83.72%, specificity of 86.36%, positive predictive value (PPV) of 92.30%, negative predictive value (NPV) of 70.07%, and overall accuracy of 84.61%. For assessment of cortical venous reflux in cavernous sinus dAVFs, hyperintensity of cortical veins on magnitude SWI showed a sensitivity of 40%, specificity of 100%, PPV of 100%, NPV of 58.82%, and accuracy of 67.69%. Cortical venous congestion on mIP SWI for evaluation of cortical venous drainage in cavernous sinus dAVFs demonstrated a sensitivity of 31.42%, specificity of 100%, PPV of 100%, NPV of 55.55%, and accuracy of 63.07%.


Among 32 cases of non-cavernous sinus dAVFs, hyperintense signal within venous structures on magnitude SWI was detected in 29 cases (90.6%). For evaluation of cortical venous reflux in non-cavernous sinus dAVFs, hyperintensity of cortical veins on magnitude SWI demonstrated high diagnostic performance, with sensitivity of 82.60%, specificity of 100%, PPV of 100%, accuracy of 87.5%, while the NPV was moderate at 69.23%. Cortical venous congestion on mIP SWI in non-cavernous sinus dAVFs also showed high diagnostic performance, with sensitivity of 91.30%, specificity of 100%, PPV of 100%, NPV of 81.82%, and accuracy of 93.75%.


Conclusion: SWI demonstrates high specificity and positive predictive value for the detection of cortical venous reflux in patients with dAVFs, particularly in non-cavernous sinus locations. However, in cavernous sinus dAVFs, the sensitivity of SWI is markedly reduced, thereby limiting its role as a screening modality in this subgroup.

Keywords

SWI, dAVF, cortical venous reflux

Article Details

References

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