Dural Entrance of the Bridging Vein into the Transverse Sinus Provides A Feliable Measure for Preoperative Planning: An Anatomical Comparison Between Cadavers and Neuroimages

摘要

OBJECTIVE: Understanding of anatomy of the transverse sinus and its associated bridging veins (BV) is essential to approach the posterior and middle incisural space. The venous phase of neuroimages has received increasing attention for preoperative planning. The aim of this study was to identify anatomical features of the dural entrance of the BVs into the transverse sinus on the cadaver and to correlate such features with that of digital subtraction angiogram (DSA), computed tomographic venography (CTV) and magnetic resonance ven0graphy (MRV). METHODS: A total of 30 adult and 76 patients were examined with anatomical dissections or DSA, CTV and MRV, respectively. Each head of the cadavers was injected with blue-coloured latex via the superior sagittal sinus and internal jugular veins. The venograms of each patient was obtained from the venous phases of DSA (60 sides out of 43 patients), CTV (40 sides out of 20 patients) or MRV (26 sides out of 13 patients). The number, diameter and location of the BVs entering the sinus were measured and compared between the cadavers and neuroimages. RESULTS: We found that the way of a BV entering the transverse sinus varied but was identifiable in images from DSA, CTV and MRV. Compared to the cadavers, DSA, CTV and MRV revealed less than 50% of the BV entering the sinus because the smaller BVs were not seen in the neuroimages. However, the distribution pattern of the dural entrance of the BVs into the transverse sinus was relatively consistent in both cadavers and neuroimages. The average diameter of veins of Labb6 was about 2.8mm. There was no difference between the cadavers, DSA, CTV and MRV examinations of the veins of Labb6. CONCLUSION: Unique anatomical features of the dural entrance of a BV into the transverse sinus in the cadaver are correlated to that of the neuroimages and thus identification of the dural entrance of the BVs with neuroimaging modalities provides a reliable measure for preoperative planning.