Jennifer Linn MD, Presenter: Nothing to Disclose

Dominik Morhard MD, Abstract Co-Author: Nothing to Disclose

Christian Schichor, Abstract Co-Author: Nothing to Disclose

Hartmut Brückmann, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Christian Glaser MD, Abstract Co-Author: Nothing to Disclose

The anatomy of the Galenic venous system (GVS) shows a high interindividual variability. Detailed information of the venous anatomy is essential for neurosurgical planning, as sacrifice of veins can result either in hemorrhage or in venous congestion. Digital subtraction angiography as well as time-of-flight and phase-contrast magnetic resonance venography have shown limitations in depicting the detailed anatomy of the deep cerebral veins. Thus, the aim of our study was to test the potential of susceptibility-weighted imaging (SWI) in the visualization of the detailed anatomy of the GVS and its interindividual variability.

SWI was performed on a 3 Tesla MR scanner (TR = 28 ms, TE = 20 ms, Trio, Siemens, Germany) in 20 healthy volunteers (11 male, mean age 38 ± 2.4 years). Two experienced neuroradiologists evaluated the exams in consensus. The presence and the respective draining vessel of the following venous structures were analyzed: internal cerebral veins (ICV), basal veins of Rosenthal (BV), posterior pericallosal veins (PPV), superior vermian and cerebellar veins (SVCVs), internal occipital veins (IOV), precentral cerebellar veins (PCVs), occipitotemporal veins (OTVs), tectal veins, and pineal veins.

The venous structures could be depicted in the following percentages and their drainage veins are given in parenthesis: ICV in 100% (great vein of Galen [GV], 100%), BC in 100% (GV, 55%; ICV, 45%), PPV in 60%, (GV, 80%; ICV, 20%), SVCVs in 90% (GV, 100%), IOV in 85% (GV, 60%; ICV, 25%; BV 15%), PCVs in 100% (GV, 90%; straight sinus, 10%), OTVs in 45% (BV, 60%; IOV, 40%), tectal veins in 80% (GV, 100%), and pineal veins in 75% (GV, 100%).

Our findings regarding the presence and the destination of the deep cerebral veins were in accordance with anatomic dissection studies. Even if no intraindividual comparison with other types of MR-venography was performed in this study, our results indicate that SWI allows for superior depiction of the cerebral venous system including small caliber vessels.

We propose SWI as a non-invasive method to optimize the planning of neurosurgical approaches to lesions in which close proximity to venous structures might be critical.

Linn, J, Morhard, D, Schichor, C, Brückmann, H, Reiser, M, Glaser, C, Visualization of the Detailed Anatomy of the Galenic Venous System and Its Interindividual Variability Using Susceptibility-weighted Imaging.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5009519.html