Morphologic evaluation of the caudal end of the inferior petrosal sinus using 3D rotational venography
Morphologic evaluation of the caudal end of the inferior petrosal sinus using 3D rotational venography
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DOI：
10.3174/ajnr.a0489
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发表时间：
2007-06-01
影响因子：
3.5
通讯作者：
Hara, M.
中科院分区：
文献类型：
--
作者：
Mitsuhashi, Y.;Nishio, A.;Hara, M.
背景与目的：岩下窦（IPS）是检查或治疗海绵窦病变的主要经静脉通路。为了成功地进行这些手术，必须对IPS和颈内静脉（IJV）交界处周围的静脉系统的解剖学有详细的了解。材料与方法：采用三维旋转静脉造影（3DRV）检查63例患者的83侧（男性26例，女性37例，平均56.5岁）。结果：IPS引流方式可分为以下6种类型，以IPS- ijv连接处水平为重点：A型，1/83侧（1.2%）IPS引流至颈静脉球；B型：29/83侧（34.9%），IPS在舌下管颅外开口水平汇入lJV；C型，IPS在31/83侧流入下颅外腔（37.3%）；D型，IPS形成一个神经丛，并在5/83侧颈静脉孔附近与lJV有多个连接（6.0%）；E型，IPS直接流入椎静脉丛（VVP），在3/83侧与IJV无连接（3.6%）；和F型，14/83侧IPS缺失（16.9%）。每种类型的特点还在于与副静脉的吻合方式。结论：从胚胎学的角度来看，这种分类似乎是合理的，可能有助于建立通过IPS进行血管内操作的治疗策略。
BACKGROUND AND PURPOSE: The inferior petrosal sinus (IPS) is the main transvenous access route used to examine or treat lesions involving the cavernous sinus. To carry out these procedures successfully, one must have a detailed knowledge of the anatomy of the venous system around the junction of the IPS and the internal jugular vein (IJV).MATERIALS AND METHODS: Eighty-three sides in 63 patients (26 men, 37 women; mean, 56.5 years of age) were examined by using 3D rotational venography (3DRV).RESULT: The drainage patterns of the IPS could be classified into the following 6 types, with emphasis on the level of IPS-IJV junction: type A, the IPS drains into the jugular bulb in 1/83 sides (1.2%); type B, the IPS drains into the lJV at the level of the extracranial opening of the hypoglossal canal in 29/83 sides (34.9%); type C, the IPS drains into the lower extracranial IJV in 31/83 sides (37.3%); type D, the IPS forms a plexus and has multiple junctions to the lJV near the jugular foramen in 5/83 sides (6.0%); type E, the IPS drains directly into the vertebral venous plexus (VVP) with no connection to the IJV in 3/83 sides (3.6%); and type F, the IPS is absent in 14/83 sides (16.9%). Each type is also characterized by the way of anastomosis with the VVP.CONCLUSION: This classification seemed to be rational from the embryologic viewpoint, and it may be useful in establishing treatment strategies that involve endovascular manipulation via the IPS.