Abstract
BACKGROUND AND PURPOSE: Intraoperative obliteration of the superior petrosal vein complex has a relevant risk of postoperative complications. A large venous diameter and the absence of anastomoses have been previously suggested as possible risk factors. 3D contrast-enhanced MRA was evaluated for the identification of superior petrosal vein anatomy.
MATERIALS AND METHODS: Twenty-five patients (10 men; age, 20–77 years) with a 3D-MRA (voxel size, 0.4 × 0.4 × 0.5 mm3) at 3T, including the posterior fossa, were retrospectively identified. Image evaluation was performed independently by 2 neuroradiologists with respect to overall image quality and the presence, location, size, tributaries, and anastomotic veins of the superior petrosal vein complex. Additionally, 8 neurosurgical cases with intraoperative validation of the venous anatomy were examined.
RESULTS: All studies were of diagnostic image quality. Interobserver agreement was excellent for image-quality measurements (r = 0.751–0.982) and good for measured vessel size (r = 0.563–0.828). A total of 83 superior petrosal veins were identified. The distribution of drainage locations and identification of tributaries and anastomotic veins were consistent with previous anatomic studies. The results showed that 4.8% of superior petrosal veins had a diameter of >2 mm and lacked a visible anastomosis. All surgical cases showed excellent agreement between the MRA and the intraoperative observations.
CONCLUSIONS: 3D-MRA with high resolution is appropriate for analyzing the size, course, tributaries, and anastomoses of the superior petrosal vein. A total of 4.8% of the identified superior petrosal veins had to be classified as potential high-risk veins. The measurements correlated with the intraoperative findings.
ABBREVIATIONS:
- SPS
- superior petrosal sinus
- SPV
- superior petrosal vein
Footnotes
Disclosures: Benjamin Bender—UNRELATED: Consultancy: Medtronic*; Travel/Accommodations/Meeting Expenses Unrelated to Activities Listed: Bayer Vital.* *Money paid to the institution.
Other patient samples with slightly different MR imaging protocols or small subgroups of the present article have been presented at the following meetings: Annual Meeting of the German Society of Skull Base Surgery, October 11–12, 2013; Tübingen, Germany; Plenary Annual Meeting of the European Skull Base Society, June 26–28, 2014; Paris, France; and Plenary Annual Meeting of the German Society of Neuroradiology, October 23–25, 2014; Cologne, Germany.
- © 2018 by American Journal of Neuroradiology