窦汇区解剖形态的MR血管成像表现

MR angiography appearance of venous sinuses in the region of the torcular Herophili

目的 探讨窦汇区解剖形态的MR血管成像 (MRA)表现及其临床意义。方法 对12 3例受检者常规进行T1WI和T2 WI磁共振检查 (1 5T) ,以排除颅内占位性病变和血管畸形。然后进行窦汇区MR血流成像。其中 72例采用了二维时间飞跃 (2DTOF)磁共振静脉成像 (MRV)方法 ,4 4例采用了三维相位对比 (3DPC)MRA方法 ,7例志愿者同时采用了上述 2种方法。结果 (1)横窦引流优势表现为右侧为主 84例 ,左侧为主 2 3例 ,基本相等 16例。 (2 )按照上矢状窦、直窦和双侧侧窦吻合关系 ,全部病例可分为 4型 :第 1型 ,包括 2种情况 :①上矢状窦和直窦汇合成一个真正的总池 ,从总池发出左右横窦 ;②上矢状窦和直窦在终末端分成 2股 ,左右分支构成两侧侧窦。第2型 ,上矢状窦引流至一侧横窦 ,直窦引流至对侧横窦。第 3型 ,上矢状窦和直窦汇合后主要向右侧横窦引流。第 4型 ,上矢状窦和直窦汇合后主要向左侧横窦引流。结论 MRA是显示窦汇区解剖形态的有效方法 ,对窦汇区解剖形态分类有助于判断横窦引流优势和现存的和 (或 )潜在的代偿通道 。

Objective To investigate the anatomic appearance in the region of the torcular Herophili by using MR and to evaluate its clinical significance Methods This study involved 123 healthy subjects All subjects underwent initial T 1W and T 2W MR examination in order to exclude intracranial occupying disease and vascular malformation Then, images of venous sinuses were obtained in the region of the torcular Herophili 72 of these subjects were examined with coronal 2D TOF MR venography (MRV), 44 cases were examined with coronal 3D PC angiography, and other 7 volunteers were examined with both of the two aforementioned methods Results (1) The venous drainage dominance showed mainly to the right side in 84 cases, mainly to the left side in 23 cases, equal drainage in 16 cases (2) According to the relation among the sinuses in the region of the torcular Herophili, all subjects in this study could be grouped into 4 types: Type 1, including those subjects in which a confluence of sinuses existed or the superior sagittal sinus and the straight sinus forked, and the forking of both sinuses joined to form the lateral sinuses Type 2, including those subjects in which the sagittal sinus drained into one side and the straight sinus drained into the other Type 3, including those subjects in which the superior sagittal sinus and the straight sinus joined and mainly drained into the right side Type 4, including those subjects in which the superior sagittal sinus and the straight sinus joined and mainly drained into the left side Conclusions MR angiography provides a useful method to show the anatomic features in the region of the torcular Herophili The pattern of the classification is considered important to assess the venous drainage dominance and helpful to deduce existent and/or potential collateral pathway These findings may be useful for diagnostic and operative procedure