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ASSESSMENT OF ANATOMICAL VARIATIONS IN CEREBRALVENOUS SINUSES USING NON CONTRAST MR VENOGRAPHY

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Dr. Anushree. C. K, Dr. Rakesh Irappa Huddar Dr. Karthik N, Dr. Kartik Katti
» doi: 10.53555/ejmcm/2024.11.05.01

Abstract

Cerebral venous system can be divided into a superficial and a deep system. The superficial system comprises of sagittal sinuses and cortical veins and these drain superficial surfaces of both cerebral hemispheres. The deep system comprises of lateral sinus, straight sinus and sigmoid sinus along with draining deeper cortical veins. Both these systems mostly drain themselves into internal jugular veins. The veins draining the brain do not follow the same course as the arteries that supply it. Generally, venous blood drains to the nearest venous sinus, except in the case of that draining from the deepest structures, which drain to deep veins. These drain, in turn, to the venous sinuses. The superficial cerebral veins can be subdivided into three groups. These are interlinked with anastomotic veins of Trolard and Labbe. However, the superficial cerebral veins are very variable. They drain to the nearest dural sinus. Thus the superolateral surface of the hemisphere drains to the superior sagittal sinus while the postero inferior aspect drains to the transverse sinus. The veins of the posterior fossa are variable in course and angiographic diagnosis of their occlusion is extremely difficult. Blood from the deep white matter of the cerebral hemisphere and from the basal ganglia is drained by internal cerebral and basal veins, which join to form the great vein of Galen that drains into the straight sinus. With the exception of wide variations of basal vein, the deep system is rather constant compared to the superficial venous system. Material And Methods: This prospective observational study with 100number Of patients undergoing MRI brain study. Patients were selected as per inclusion and exclusion criteria. Informed consent obtained from the parents/guardian (regarding inclusion in the study )in regional language Results: Non contrast MR venography can be used as safe imaging modality for screening of cerebral venous system especially in cases of cerebral venous thrombosis and parasagittal meningioma’s. Pitfalls should be kept in mind before giving the diagnosis of cerebral venous thrombosis in early stages without parenchymal findings. In highly suspicious pathological cases, contrast study can be performed for confirming the findings. However, further larger study and standard reference imaging modalities are recommended to validate the data of our study.   Conclusion: Non contrast MR venography is one of the best and safe imaging modality to study the dural venous sinuses, Vein of Galen, internal cerebral vein, basal vein of Rosenthal and major anastomotic vein. Variations in the calibre of the sinuses and flowgaps were more common in transverse sinuses, which are potential pitfalls for sinus thrombosis. Sigmoid sinus asymmetry with ipsilateral small internal jugular vein excludes thrombosis of sigmoid sinus. In superior sagittal sinus, straight sinus and deep cerebral veins, flowgaps were less common. Hence such findings should raise a suspicion of pathology. Split in the posterior 1/3rd and rostral hypogenesis of superior sagittal sinus are potential pitfalls in the diagnosis of superior sagittal sinus thrombosis.

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