Can Intracranial Venous Reflux Be Detected from Transcondylar Approach? The Results of a Fusion Imaging Study

Česká verzia

Authors: D. Školoudík ^1,2; M. Kuliha ¹; M. Roubec ¹; J. Havelka ³; F. Formagnana ⁴; L. Forzoni ⁴; R. Herzig ²
Authors place of work: Neurologická klinika FN Ostrava ¹; Neurologická klinika LF UP a FN Olomouc ²; Ústav radiodiagnostický FN Ostrava ³; ESAOTE, Firenze, Italy ⁴
Published in the journal: Cesk Slov Neurol N 2012; 75/108(5): 611-616
Category: Short Communication

Summary

Introduction:
Transcondylar approach is a new approach used for detection of chronic cerebro-spinal venous insufficiency (CCSVI) and venous reflux in intracranial venous system in patients with multiple sclerosis. The aim of the study was to assess suitability of the transcondylar approach for monitoring blood flow through the deep cerebral veins and venous sinuses.

Material and methods:
Brain magnetic resonance imaging and transcranial duplex sonography (TCCS) from transtemporal and transcondylar approaches using the new technology – Fusion Imaging – were performed in six volunteers and five patients with multiple sclerosis.

Results:
In all subjects, the root mean square error was <0.5 cm and the accuracy of the system, measured using a registration pen, was <1 mm. In all subjects, all arteries of the circle of Willis, deep middle cerebral vein, basal vein of Rosenthal, superior and inferior petrosal sinuses, cavernous and transversal sinuses and confluens sinuum were visible from transtemporal approach. However, transcondylar approach enabled depiction of the internal carotid artery siphon in three (27.3%) and middle cerebral artery in one (9%) subject only. Blood flow signal from cavernous, inferior or superior petrosal sinuses and deep brain veins was not detected in any subject even when the Fusion Imaging was used. Bidirectional Doppler signal from the cavernous sinus region was evaluated as an artefact.

Conclusion:
The study results showed that TCCS transcondylar approach is not suitable for standard detection of intracranial venous reflux.

Key words:
ultrasound – magnetic resonance imaging – reflux – venous system – fusion imaging

Zdroje

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