A Phase-Contrast MRI Study of Physiologic Cerebral Venous Flow

Abstract

Although crucial in regulating intracranial hydrodynamics, the cerebral venous system has been rarely studied because of its structural complexity and individual variations. The purpose of our study was to evaluate the organization of cerebral venous system in healthy adults. Phase-contrast magnetic resonance imaging (PC-MRI) was performed in 18 healthy volunteers, in the supine position. Venous, arterial, and cerebrospinal fluid (CSF) flows were calculated. We found heterogeneous individual venous flows and variable side dominance in paired veins and sinuses. In some participants, the accessory epidural drainage preponderated over the habitually dominant jugular outflow. The PC-MRI enabled measurements of venous flows in superior sagittal (SSS), SRS (straight), and TS (transverse) sinuses with excellent detection rates. Pulsatility index for both intracranial (SSS) and cervical (mainly jugular) levels showed a significant increase in pulsatile blood flow in jugular veins as compared with that in SSS. Mean cervical and cerebral arterial blood flows were 714+/-124 and 649+/-178 mL/min, respectively. Cerebrospinal fluid aqueductal and cervical stroke volumes were 41+/-22 and 460+/-149 microL, respectively. Our results emphasize the variability of venous drainage for side dominance and jugular/epidural organization. The pulsatility of venous outflow and the role it plays in the regulation of intracranial pressure require further investigation.

Reproducibility of Cerebrospinal Venous Blood Flow and Vessel Anatomy with the Use of Phase Contrast-Vastly Undersampled Isotropic Projection Reconstruction and Contrast-Enhanced MRA

“…Waveforms show little variation through time, indicating low pulsatility far from the heart in the cerebral veins. This work confirms earlier 2D phase-contrast MR work in the cerebral veins performed by Stoquart-El Sankari et al 25 The lack of retrograde flow in all deep cerebral veins and intracranial veins substantiates the work of Wattjes et al, 26 in which 2D phase-contrast MR was used to measure flow in the straight sinus and internal cerebral veins in both healthy control subjects and patients with MS.…”

The manifestation of vortical and secondary flow in the cerebral venous outflow tract: An in vivo MR velocimetry study

“…2D-flow analysis of CVOT can offer valuable insights into the presenting pathology such as information on a distinctly lower pulsatility index in the sigmoid sinus compared to the IJV, as reported in this study and the potential impact that this might have on regulating the intracranial pressure requires further exploration (Stoquart-ElSankari et al, 2009). Nevertheless, only time-resolved volumetric flow measurements, such as those clinically offered by 4D-Flow MRI, can provide the necessary information for analysis of hemodynamic induced phenomena such as cerebral venous vasculature remodeling, morphological changes, flow regulation, lumenal wall motion, TKE analysis (Kefayati et al, 2016), and bruit generation with venous etiology and this defines the scope of our future studies.…”

Sigmoid Sinus Characteristics Correlate with Early Clinical and Imaging Surrogates in Anterior Circulation Ischemic Stroke

“…Moreover, we did not account for other accessory venous outflow patterns such as cervical epidural venous system through anterior condylar confluent system. However, this is a rare constellation [16, 17]. Furthermore, we used CTA technique that is not time-resolved, and as the consequence, the measured density of the venous compartment decreases from sagittal sinus to jugular bulb.…”