Intracranial magnetic resonance venography in healthy individuals: normal anatomy and variations of the cerebral venous system

Abstract

Objective: To evaluate the basic appearance and variation of the venous sinuses and veins in healthy individuals. Methods: Prospectively-recruited healthy volunteers completed a questionnaire and underwent magnetic resonance imaging plus contrast-enhanced magnetic resonance venography (CE-MRV) to measure their sinus diameters. Anatomical variations of cerebral venous sinuses were evaluated. Results: Fifty-eight individuals were included. The mean diameter of the left transverse sinus (LTS) (5.37±1.35 mm) was significantly smaller than that of the right transverse sinus (RTS) (6.65±1.57 mm) (P<0.001), and the average discrepancy was 19.2%. RTS dominance was noted in 55.1% of cases. Four superior sagittal sinus (SSS) anatomical variations were found. Type A was the most common and was present in 43 participants (74.1%). The SSS preferentially drained into the RTS in 32 patients (55.2%), and arach-noid granulation was observed in the transverse sinus (TS) and SSS in patients. According to our reclassification combined with Osborn’s previous research, we found that the SSS commonly drained into the RTS and that the straight sinus (StS) branched into both TSs. Conclusions: A 19% difference between the LTS and RTS provides a threshold for TS lateral dominance instead of a TS abnormality. Clinicians and radiologists should not ignore the influence of acquired pathology when the SSS drains in a non-RTS-dominant manner. Anatomical variations of the torcular herophili are frequent; the most commonly observed was the StS branching into both TSs, with the SSS draining into the RTS.

Keywords

transverse sinus / healthy individuals / anatomy / magnetic resonance venography / cerebral venous system