Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Department of Neurosurgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan.
Clin Neuroradiol. 2024 Mar;34(1):67-74. doi: 10.1007/s00062-023-01327-6. Epub 2023 Aug 8.
There has been limited literature regarding the bridging veins (BVs) of the medulla oblongata around the foramen magnum (FM). The present study aims to analyze the normal angioarchitecture of the BVs around the FM using slab MIP images of three-dimensional (3D) angiography.
We collected 3D angiography data of posterior fossa veins and analyzed the BVs around the FM using slab MIP images. We analyzed the course, outlet, and number of BVs around the FM. We also examined the detection rate and mean diameter of each BV.
Of 57 patients, 55 patients (96%) had any BV. The median number of BVs was two (range: 0-5). The BVs originate from the perimedullary veins and run anterolaterally to join the anterior condylar vein (ACV), inferior petrosal sinus, sigmoid sinus, or jugular bulb, inferolaterally to join the suboccipital cavernous sinus (SCS), laterally or posterolaterally to join the marginal sinus (MS), and posteriorly to join the MS or occipital sinus. We classified BVs into five subtypes according to the draining location: ACV, jugular foramen (JF), MS, SCS, and cerebellomedullary cistern (CMC). ACV, JF, MS, SCS, and CMC BVs were detected in 11 (19%), 18 (32%), 32 (56%), 20 (35%), and 16 (28%) patients, respectively. The mean diameter of the BVs other than CMC was 0.6 mm, and that of CMC BV was 0.8 mm.
Using venous data from 3D angiography, we detected FM BVs in most cases, and the BVs were connected in various directions.
关于延髓周围颅颈交界区（foramen magnum，FM）的桥静脉（bridging veins，BVs），文献报道较少。本研究旨在通过三维（3D）血管造影的容积再现最大密度投影（MIP）图像分析 FM 周围 BVs 的正常血管构筑。
我们收集了后颅窝静脉的 3D 血管造影数据，并使用容积再现 MIP 图像分析 FM 周围的 BVs。我们分析了 FM 周围 BVs 的走行、出口和数量。还检查了每条 BV 的检出率和平均直径。
57 例患者中，55 例（96%）存在任何 BVs。BVs 的中位数数量为 2 条（范围：0-5 条）。BVs 起源于软脑膜静脉，向外侧前走行汇入前髁静脉（anterior condylar vein，ACV）、岩下窦、乙状窦或颈静脉球，向外侧后汇入枕下海绵窦（suboccipital cavernous sinus，SCS），向外侧或后外侧汇入边缘窦（marginal sinus，MS），向后汇入 MS 或枕窦。根据引流部位，我们将 BVs 分为五型：ACV、颈静脉孔（jugular foramen，JF）、MS、SCS 和小脑延髓池（cerebellomedullary cistern，CMC）。11 例（19%）、18 例（32%）、32 例（56%）、20 例（35%）和 16 例（28%）患者分别检测到 ACV、JF、MS、SCS 和 CMC BVs。除 CMC BV 外，其他 BV 的平均直径为 0.6mm，而 CMC BV 的直径为 0.8mm。
使用 3D 血管造影的静脉数据，我们在大多数情况下检测到 FM BVs，并且这些 BVs 以各种方向连接。
