Taoka Toshiaki, Fukusumi Akio, Miyasaka Toshiteru, Kawai Hisashi, Nakane Toshiki, Kichikawa Kimihiko, Naganawa Shinji
From the Department of Radiology, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan (T.T., H.K., T.N., S.N.); and Department of Radiology, Nara Medical University, Kashihara, Japan (A.F., T.M., K.K.).
Radiographics. 2017 Jan-Feb;37(1):281-297. doi: 10.1148/rg.2017160061.
Deep medullary veins drain into subependymal veins with four convergence zones and show parallel distribution patterns adjacent to the body or inferior horn and a radial pattern in the frontal horn or trigon of the lateral ventricle. As white matter imaging develops such as diffusion tensor imaging or susceptibility-weighted imaging, requirements for understanding of white matter structures are increasing, not only for understanding of neuronal tracts but also for that of other structures including the fine anatomy of white matter vessels. Some disorders are related to deep medullary veins and show characteristic distributions of the lesions indicating the relationship to the medullary veins. When lesions show a parallel or radial distribution pattern in the certebral deep white matter, disorders related to deep medullary veins should be considered for differential diagnosis. In this review, we discuss disorders related to deep medullary veins, including (a) anomalies of the medullary veins, (b) hemorrhagic disorders related to the medullary veins (diffuse vascular injury due to high-energy trauma, deep medullary vein engorgement/thrombosis in neonates), (c) inflammatory changes that spread along the medullary veins, (d) neoplasms within the medullary veins, and (e) metabolic changes that lead to altered visualization of medullary veins. Understanding the anatomic structure of medullary veins in the cerebral hemisphere and becoming familiar with disorders in which the medullary veins play a major role in disease development may be helpful in the interpretation of brain images. RSNA, 2017.
深髓静脉汇入具有四个汇聚区的室管膜下静脉，在胼胝体体部或下角附近呈平行分布模式，在侧脑室额角或三角区呈放射状分布模式。随着诸如扩散张量成像或磁敏感加权成像等白质成像技术的发展，不仅对于理解神经束，而且对于理解包括白质血管精细解剖结构在内的其他结构，对白质结构的理解需求都在增加。一些疾病与深髓静脉相关，并显示出具有特征性的病变分布，提示与髓静脉的关系。当病变在脑深部白质中呈平行或放射状分布模式时，应考虑与深髓静脉相关的疾病进行鉴别诊断。在本综述中，我们讨论与深髓静脉相关的疾病，包括：（a）髓静脉异常；（b）与髓静脉相关的出血性疾病（高能创伤导致的弥漫性血管损伤、新生儿深髓静脉充血/血栓形成）；（c）沿髓静脉蔓延的炎症变化；（d）髓静脉内的肿瘤；以及（e）导致髓静脉显示改变的代谢变化。了解大脑半球髓静脉的解剖结构并熟悉髓静脉在疾病发展中起主要作用的疾病，可能有助于脑影像的解读。RSNA，2017年。
