title: Vascular Complications of Intercavernous Sinuses during Transsphenoidal Surgery: An Anatomical Analysis Based on Autopsy and Magnetic Resonance Venography.
abstract: OBJECTIVE
  Vascular complications induced by intercavernous sinus injury during dural opening in the transsphenoidal surgery may contribute to incomplete tumour resections. Preoperative neuro-imaging is of crucial importance in planning surgical approach. The aim of this study is to correlate the microanatomy of intercavernous sinuses with its contrast-enhanced magnetic resonance venography (CE-MRV).
  
  
  METHODS
  Eighteen human adult cadavers and 24 patients were examined based on autopsy and CE-MRV. Through dissection of the cadavers and CE-MRV, the location, shape, number, diameter and type of intercavernous sinuses were measured and compared.
  
  
  RESULTS
  Different intercavernous sinuses were identified by their location and shape in all the cadavers and CE-MRV. Compared to the cadavers, CE-MRV revealed 37% of the anterior intercavernous sinus, 48% of the inferior intercavernous sinus, 30% of the posterior intercavernous sinus, 30% of the dorsum sellae sinus and 100% of the basilar sinus. The smaller intercavernous sinuses were not seen in the neuro-images. According to the presence of the anterior and inferior intercavernous sinus, four types of the intercavernous sinuses were identified in cadavers and CE-MRV, and the corresponding operative space in the transsphenoidal surgical approach was implemented.
  
  
  CONCLUSIONS
  The morphology and classification of the cavernous sinus can be identified by CE-MRV, especially for the larger vessels, which cause bleeding more easily. Therefore, CE-MRV provides a reliable measure for individualized preoperative planning during transsphenoidal surgery.
authors.affiliation: Department of Anatomy, Anhui Medical University, Hefei, Anhui, China.
authors.forename: Xuefei
authors.initials: X
authors.lastname: Deng
authors.affiliation: Department of Anatomy, Anhui Medical University, Hefei, Anhui, China.
authors.forename: Shijun
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Ya
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Song
authors.affiliation: Ultrasonic Center, The 105th Hospital of PLA, Hefei, Anhui, China.
authors.forename: Yongchao
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Anhui Provincial Hospital, Hefei, Anhui, China.
authors.forename: Dongxue
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Anatomy, Anhui Medical University, Hefei, Anhui, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Han
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D001344:Autopsy; D002102:Cadaver; D002426:Cavernous Sinus / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010690:Phlebography / Q000379:methods*; D015203:Reproducibility of Results; D055815:Young Adult
chemical_list: D003287:Contrast Media