Usefulness of novel fusion imaging with zero TE sequence and contrast-enhanced T1WI for cavernous sinus dural arteriovenous fistula

Evaluation of access routes and shunting points plays a crucial role in the treatment of cavernous sinus dural arteriovenous fistulas (CS-dAVF). Generally, these evaluations are performed using three-dimensional rotation angiography. However, assessing access routes becomes challenging in cases lacking anterior or posterior drainage routes. Zero TE magnetic resonance imaging (MRI) is an innovative technique enabling the visualization of cortical bone. By merging fusion images of zero TE and contrast-enhanced T1 weighted imaging (CE-T1WI), enhanced arteries can be visualized, resembling cranial bone-like three-dimensional rotation angiography. To determine the usefulness of fusion images in evaluating access routes and shunting points for dural arteriovenous fistulas, a comparison was made between these fusion images and three-dimensional rotation angiography in the same case. This report describes the application of fusion images in evaluating access routes and shunting points.