枕静脉交通支：假性脑瘤的一个可能标志物。
The Occipital Emissary Vein: A Possible Marker for Pseudotumor Cerebri.
机构信息
From the Neuroradiology Unit (A.H., C.G.-C., D.S.M.), Service of Diagnostic and Interventional Imaging, Sion Hospital, Sion, Valais, Switzerland
Department of Interventional Neuroradiology (A.H., P.G.).
出版信息
AJNR Am J Neuroradiol. 2019 Jun;40(6):973-978. doi: 10.3174/ajnr.A6061. Epub 2019 May 9.
BACKGROUND AND PURPOSE
Transverse sinus stenosis can lead to pseudotumor cerebri syndrome by elevating the cerebral venous pressure. The occipital emissary vein is an inconstant emissary vein that connects the torcular herophili with the suboccipital veins of the external vertebral plexus. This retrospective study compares the prevalence and size of the occipital emissary vein in patients with pseudotumor cerebri syndrome with those in healthy control subjects to determine whether the occipital emissary vein could represent a marker of pseudotumor cerebri syndrome.
MATERIALS AND METHODS
The cranial venous system of 46 adult patients with pseudotumor cerebri syndrome (group 1) was studied on CT venography images and compared with a group of 92 consecutive adult patients without pseudotumor cerebri syndrome who underwent venous assessment with gadolinium-enhanced 3D-T1 MPRAGE sequences (group 2). The presence of an occipital emissary vein was assessed, and its proximal (intraosseous) and distal (extracranial) maximum diameters were measured and compared between the 2 groups. Seventeen patients who underwent transverse sinus stent placement had their occipital emissary vein diameters measured before and after stent placement.
RESULTS
Thirty of 46 (65%) patients in group 1 versus 29/92 (31.5%) patients in group 2 had an occipital emissary vein ( < .001). The average proximal and distal occipital emissary vein maximum diameters were significantly larger in group 1 (2.3 versus 1.6 mm, <.005 and 3.3 versus 2.3 mm, < .001). The average maximum diameters of the occipital emissary vein for patients who underwent transverse sinus stent placement were larger before stent placement than after stent placement: 2.6 versus 1.8 mm proximally ( < .06) and 3.7 versus 2.6 mm distally ( < .005).
CONCLUSIONS
Occipital emissary veins are more frequent and larger in patients with pseudotumor cerebri syndrome than in healthy subjects, a finding consistent with their role as collateral venous pathway in transverse sinus stenosis. A prominent occipital emissary vein is an imaging sign that should raise the suspicion of pseudotumor cerebri syndrome.
背景与目的
横窦狭窄可通过升高脑静脉压导致假性脑瘤综合征。枕导静脉是一条不定型的导静脉，连接窦汇与枕下外椎静脉丛的静脉。本回顾性研究比较了假性脑瘤综合征患者与健康对照组枕导静脉的发生率和大小，以确定枕导静脉是否可以作为假性脑瘤综合征的标志物。
材料与方法
对 46 例成人假性脑瘤综合征患者（第 1 组）的颅静脉系统进行 CT 静脉造影图像研究，并与 92 例连续成人无假性脑瘤综合征患者（第 2 组）进行比较，后者行钆增强 3D-T1 MPRAGE 序列静脉评估。评估枕导静脉的存在，并测量其近端（骨内）和远端（颅外）最大直径，并在两组之间进行比较。对 17 例行横窦支架置入术的患者，测量支架置入前后枕导静脉直径。
结果
第 1 组 46 例患者中有 30 例（65%），第 2 组 92 例患者中有 29 例（31.5%）存在枕导静脉（<0.001）。第 1 组枕导静脉近端和远端最大直径明显大于第 2 组（2.3 毫米比 1.6 毫米，<0.005 和 3.3 毫米比 2.3 毫米，<0.001）。行横窦支架置入术的患者，支架置入前枕导静脉最大直径大于支架置入后：近端 2.6 毫米比 1.8 毫米（<0.06），远端 3.7 毫米比 2.6 毫米（<0.005）。
结论
与健康对照组相比，假性脑瘤综合征患者的枕导静脉更频繁、更大，这与它们在横窦狭窄时作为侧支静脉途径的作用一致。明显的枕导静脉是假性脑瘤综合征的影像学征象，应引起对假性脑瘤综合征的怀疑。
Zotero 插件