Craniocervical junction venous anatomy around the suboccipital cavernous sinus: evaluation by MR imaging

Abstract

The present study evaluated the venous anatomy of the craniocervical junction, focusing on the suboccipital cavernous sinus (SCS), a vertebral venous plexus surrounding the horizontal portion of the vertebral artery at the skull base. MR imaging was reviewed to clarify the venous anatomy of the SCS in 33 patients. Multiplanar reconstruction MR images were obtained using contrast-enhanced three-dimensional fast spoiled gradient-recalled acquisition in the steady state (3-D fast SPGR) with fat suppression. Connections with the SCS were evaluated for the following venous structures: anterior condylar vein (ACV); posterior condylar vein (PCV); lateral condylar vein (LCV); vertebral artery venous plexus (VAVP); and anterior internal vertebral venous plexus (AVVP). The SCS connected with the ACV superomedially, with the VAVP inferolaterally, and with the AVVP medially. The LCV connected with the external orifice of the ACV and superoanterior aspect of the SCS. The PCV connected with the posteromedial aspect of the jugular bulb and superoposterior aspect of the SCS. The findings of craniocervical junction venography performed in eight patients corresponded with those on MR imaging, other than with regard to the PCV. Contrast-enhanced 3-D fast SPGR allows visualization of the detailed anatomy of these venous structures, and this technique facilitates interventions and description of pathologies occurring in this area.

Venous structures at the craniocervical junction: anatomical variations evaluated by multidetector row CT

“…The anatomical architectures of the LCV and PCV could be evaluated; the LCV was found to be absent in 27 sides (27%) and the PCV was absent in 33 sides (33%). These results presented a similar frequency to the results of a previous study [7].…”

“…Previous radiological studies of the anatomy and/or variations of craniocervical venous structures have been carried out using transcatheter angiography or MRI [2][3][4][5][6][7][8]. Takahashi et al [7] evaluated the venous anatomy around the SCS using contrast-enhanced MRI with three-dimensional fast spoiled gradient-recalled acquisition in the steady state (3D-SPGR) with fat suppression; all venous structures could be clearly depicted.…”

“…Takahashi et al [7] evaluated the venous anatomy around the SCS using contrast-enhanced MRI with three-dimensional fast spoiled gradient-recalled acquisition in the steady state (3D-SPGR) with fat suppression; all venous structures could be clearly depicted. Contrast-enhanced three-dimensional fast gradient-echo MRI has the advantage of depicting skull base venous structures because of its high resolution between veins and bones [11].…”

“…Knowledge of the anatomical relationships and variations of these veins is necessary not only for radiological diagnosis, but also when considering surgical or endovascular treatment of skull base diseases. Some investigators have previously reported the anatomy of and variations in these veins using anatomical and radiological methods with conventional angiography or contrast-enhanced MRI [2][3][4][5][6][7][8]. CT has been recognised as inadequate for evaluations of the posterior fossa owing to artefacts from bony structures; however, recent applications of multidetector row CT (MDCT) enable us to evaluate the posterior fossa with thin-sectional axial images and/or three-dimensional reconstructed images.…”

Endovascular Treatment of Dural Arteriovenous Fistulas of the Anterior or Posterior Condylar Vein

“…The PCV originates from the bulb of the jugular vein, the most medial point of the sigmoid sinus or the ACC ( Fig. 4b; [10,12,13]). It terminates in the vertebral artery venous plexus (VAVP) or deep cervical veins (DCV).…”