Analysis of the venous channel within the clivus using multidetector computed tomography digital subtraction venography
Analysis of the venous channel within the clivus using multidetector computed tomography digital subtraction venography
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DOI：
10.1007/s00234-017-1784-4
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发表时间：
2017-03-01
期刊：
影响因子：
2.8
通讯作者：
Yoshida, Kazunari
中科院分区：
文献类型：
--
作者：
Mizutani, Katsuhiro;Toda, Masahiro;Yoshida, Kazunari
目的虽然神经放射科医生和颅底神经外科医生意识到斜坡内静脉的存在，但这种血管在文献中很少被描述。方法回顾分析50例未破裂动脉瘤的CT数字减影静脉造影(CT-DSV)图像。结果14例(28.0%)共检出18条干静脉。1/2的发出静脉与岩下静脉在斜坡中段相连。斜坡双倍静脉的显示率为14.0%，其中42.9%为鞍前型。CDV上端与海绵间后静脉或基底神经丛的吻端相连，CDV与上颌下静脉、颈内静脉、岩下静脉和上颌下静脉之间存在侧支通道，CDV在海绵窦、颈内静脉、岩下静脉和上颌窦之间提供侧支通道。了解斜坡和CDV的干静脉对颅底手术，特别是鼻内窥镜颅底手术有重要价值。
Purpose Although neuroradiologists and skull base neurosurgeons are aware of the existence of veins within the clivus, such vessels have seldom been described in the literature. The aim of the present study is to elucidate the detailed venous structure of the clivus.Methods Computed tomography digital subtraction venography (CT-DSV) images of 50 unruptured aneurysm cases were examined retrospectively.Results Eighteen emissary veins were identified in 14 (28.0%) cases. A half of the emissary veins connected the inferior petrosal sinus with the inferior petro-occipital vein (IPOV) in the middle clivus. The clival diploic vein (CDV) was identified in 14.0% of cases, 42.9% of which had the clivus of the presellar type. The CDV was connected to the posterior intercavernous sinus or the rostral end of the basilar plexus superiorly, and was connected to the IPOV, anterior condylar vein, marginal sinus, or the anterior condylar confluence.Conclusion The CDV provides collateral channels between the cavernous sinus and the internal jugular vein and the inferior petrosal sinus and the IPOV. Understanding of the emissary veins in the clivus and the CDVis valuable for skull base surgery, especially for endonasal endoscopic skull base procedures.