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The authors compared the efficacy of volumetric high-resolution heavily T2-weighted and time-resolved contrast-enhanced images in spinal vascular malformation diagnosis and feeder characterization and assessed whether a combined evaluation improved the overall accuracy of diagnosis in 28 patients. Both sequences demonstrated 100% sensitivity and 93.5% accuracy for the detection of spinal vascular malformations. Volumetric high-resolution heavily T2-weighted imaging was superior to time-resolved contrast-enhanced MR imaging for identification of spinal cord arteriovenous malformations while the opposite was observed for perimedullary arteriovenous fistulas. Both sequences showed equal sensitivity (100%) and accuracy (87%) for spinal dural arteriovenous fistulas. They conclude that combined volumetric high-resolution heavily T2-weighted imaging and time-resolved contrast-enhanced MR imaging can improve the sensitivity and accuracy of spinal vascular malformation diagnosis, classification, and feeder characterization.