Cheng Yaqin, Li William A, Fan Xingjuan, Li Xiaohua, Chen Jian, Wu Yan, Meng Ran, Ji Xunming
a Department of Neurology, Xuanwu Hospital , Capital Medical University , Beijing , China.
b Department of Neurology , Affiliated Hospital of Nantong University , Nantong , China.
Neurol Res. 2017 Jun;39(6):509-515. doi: 10.1080/01616412.2017.1323383. Epub 2017 May 11.
The configuration of the confluence of sinuses differs not only between individuals, but also between the two brain hemispheres, making the anatomical classification of this region difficult. In this study, we evaluated the anatomy of the confluence of sinuses and ascertained the accuracy and usefulness of digital subtraction angiography (DSA) in the evaluation of cerebral veins.
Bilateral carotid and vertebral artery angiographies were performed in 500 adult patients to evaluate the anatomy of the confluence of sinuses and contributory venous sinuses. We appraised the anatomy of the sinuses adjacent to the confluence, the lateralization of venous draining into the transverse sinuses (TSs), the communications between the TSs, and the presentation of the occipital sinus (OS).
Based on the anatomical descriptions of Osborn's Brain (Diagnostic Cerebral Angiography, 2nd edition), we delineated 10 different configurations of the confluence of sinuses that showed connections among the superior sagittal sinus, the straight sinus, and the left and right TSs. Right side dominant transverse sinus accounted for 49% of the cases. Direct communication between the TSs accounted for 46.4% of the cases. Indirect communication accounted for 51.6% of the case, and absence of communication between the left and the right TS accounted for 2%. Lastly, the presence of OS was observed in 6% of the cases.
DSA promises to be an effective technique for studying the anatomy and normal variations of the confluence of sinuses, providing useful information for the diagnosis of cerebral venous diseases, and ensuring safer surgical procedures.
窦汇的形态不仅因人而异，而且在大脑两半球之间也存在差异，这使得该区域的解剖学分类变得困难。在本研究中，我们评估了窦汇的解剖结构，并确定了数字减影血管造影（DSA）在评估脑静脉方面的准确性和实用性。
对500例成年患者进行双侧颈动脉和椎动脉血管造影，以评估窦汇及引流静脉窦的解剖结构。我们评估了窦汇附近窦的解剖结构、流入横窦（TSs）的静脉的侧别、TSs之间的交通以及枕窦（OS）的表现。
根据奥斯本《大脑》（《诊断性脑血管造影》第2版）中的解剖学描述，我们描绘了10种不同的窦汇形态，这些形态显示了上矢状窦、直窦以及左右TSs之间的连接。右侧优势横窦占49%的病例。TSs之间的直接交通占46.4%的病例。间接交通占51.6%的病例，左右TSs之间无交通占2%。最后，6%的病例观察到OS的存在。
DSA有望成为研究窦汇解剖结构和正常变异的有效技术，为脑静脉疾病的诊断提供有用信息，并确保手术过程更安全。
