The evaluation of cerebral venous normal anatomy and variations by phase-contrast cranial magnetic resonance venography

AbstractAnatomy is the key to accurate imaging interpretation. It is essential for radiologists to thoroughly understand the normal anatomy and spatial relationships of the stomach and duodenum to accurately localize the site of abnormality. In this article, we describe in detail the gross and applied radiological anatomy of the stomach and duodenum, and the current role of various radiological investigations (including barium studies, endoscopic ultrasonography, computed tomography, and magnetic resonance imaging) in the evaluation of the diseases involving the stomach and duodenum.

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Use of magnetic resonance venography for inferior petrosal sinus sampling

The Journal of Vascular Access ◽

10.1177/1129729821997263 ◽

2021 ◽

pp. 112972982199726

Author(s):

Kikutaro Tokairin ◽

Toshiya Osanai ◽

Noriyuki Fujima ◽

Kinya Ishizaka ◽

Hiroaki Motegi ◽

...

Keyword(s):

Magnetic Resonance ◽

Radiation Dose ◽

Interventional Procedure ◽

Anatomical Variations ◽

Magnetic Resonance Venography ◽

University Hospital ◽

Inferior Petrosal Sinus ◽

Success Rates ◽

Intravenous Catheter ◽

Patient Demographics

Background: Inferior petrosal sinus (IPS) sampling (IPSS) is a transvenous interventional procedure performed to diagnose Cushing’s disease. The reported IPSS failure rate is approximately 10% because IPS catheter delivery is conducted blindly and is challenging because of IPS anatomical variations. This study aimed to evaluate the usefulness of preprocedural magnetic resonance venography (MRV) for assessing IPS access routes before IPSS. Methods: Nineteen consecutive patients who underwent IPSS at a single university hospital in Japan were retrospectively studied. A preprocedural MRV protocol optimized to visualize the IPS before IPSS was established and utilized in the eight most recent cases. An IPSS procedure was considered successful when bilateral IPS catheterization was accomplished. Patient demographics, IPSS success rate, and radiation dose required during IPSS were compared between two groups: MRV group ( N = 8) and no-MRV group ( N = 11) before IPSS. Results: There were no significant differences in age, sex, and IPSS success rates between the groups. The average radiation dose was 663.6 ± 246.8 (SD) mGy and 981.7 ± 389.5 (SD) mGy in the MRV group and no-MRV group, respectively. Thus, there was a significant reduction in radiation exposure in the MRV group ( p = 0.044). Catheterization of the left IPS was unsuccessful in only one patient in the MRV group owing to IPS hypoplasty, as found on the MRV. Conclusions: Hypoplastic IPSs occur in patients and can complicate IPSS. Preprocedural MRV assessment is useful for understanding venous anatomy and preventing unnecessary intravenous catheter manipulation during IPSS, which involves blind manipulation around the IPS.

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Assessment of Cerebrospinal Fluid Hydrodynamics Using Magnetic Resonance Imaging in Postcraniospinal Surgery Patients

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1734362 ◽

2021 ◽

Author(s):

Pankaj Arora ◽

Kanica Rawat ◽

Rajiv Azad ◽

Kehkashan Chouhan

Keyword(s):

Magnetic Resonance Imaging ◽

Cerebrospinal Fluid ◽

Magnetic Resonance ◽

Clinical Outcome ◽

Phase Contrast ◽

Flow Dynamics ◽

Resonance Imaging ◽

Csf Flow ◽

Group I ◽

Group Ii

Abstract Objective Aim of this study is to evaluate the effect of craniospinal interventions on cerebrospinal fluid (CSF) flow hydrodynamics and study the correlation of postoperative changes in flow alteration with clinical outcome. Materials and Methods Fifty patients who underwent various craniospinal procedures were studied using conventional and phase-contrast magnetic resonance imaging (PCMRI) protocol. CSF flow quantification was performed at cerebral aqueduct, foramen magnum, C2–3, and D12–L1 vertebral levels with site showing maximal alteration of CSF flow dynamics considered as the region of interest. Velocity encoding was kept at 20 cm/s. Patients with pathology atcraniovertebral junction were considered separately (group I) from others (group II) due to different flow dynamics. Follow-up scans were performed after an interval of 1 month for temporal evaluation of changes in CSF flow dynamics. Results Patients in both groups showed a significant change in peak CSF velocity postoperatively (mean change of 1.34 cm/s in group I and 0.28 cm/s in group II) with bidirectional improvement in flow on cine-phase-contrast qualitative images. Regional pain (82%) and headache (46%) were seen in most of the patients preoperatively. Postoperatively clinical symptoms improved in 59.5%, static in 26.2%, and worsened in 14.3%. In both the groups, an improvement in clinical symptomatology had significant correlation with mean changes in peak CSF velocity postoperatively (p = 0.04 in both groups). Conclusion PCMRI can effectively evaluate changes in CSF flow noninvasively both pre- and postoperatively. This may have potential role in determining clinical outcome and prognosis of patients undergoing procedures in craniospinal axis.

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