title: Diagnosis of Transverse Sinus Hypoplasia in Magnetic Resonance Venography: New Insights Based on Magnetic Resonance Imaging in Combined Dataset of Venous Outflow Impairment Case-Control Studies: Post Hoc Case-Control Study.
abstract: In previous studies of transverse sinus (TS) hypoplasia, discrepancies between TS diameter measured by magnetic resonance venography (MRV) and contrast T1-weighted magnetic resonance (contrast T1) were observed. To investigate these discrepancies, and considering that TS hypoplasia is associated with neurological disorders, we performed a post hoc analysis of prospectively collected data from 3 case-control studies on transient global amnesia (TGA), transient monocular blindness (TMB), and panic disorders while retaining the original inclusion and exclusion criteria. Magnetic resonance (MR) imaging of 131 subjects was reviewed to evaluate TS diameter and the location and degree of venous flow stenosis and obstruction.MRV without contrast revealed that TS hypoplasia was observed in 69 subjects, whom we classified into 2 subgroups according to the concordance with contrast T1 observations: concordance indicated anatomically small TS (30 subjects), and discrepancy indicated that the MRV diagnosis is in fact flow-related and that TS is not anatomically small (39 subjects). The latter subgroup was associated with at least 1 site of venous compression/stenosis in the internal jugular vein (IJV) or the left brachiocephalic vein (BCV) (P < 0.001), which was significantly larger in patients than controls. Compensatory dilatation of contralateral TS diameter was only observed with MRV, not with contrast T1 imaging.The clinical implication of these results is that using MRV only, IJV/BCV compression/stenosis may be misdiagnosed as TS hypoplasia. And contralateral TS have no compensatory dilatation in its diameter in contrast T1 imaging, just compensatory increased flow volume.
authors.affiliation: From the Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin, China (KH, JW), Department of Neurology, College of Medicine, Kaohsiung Medical University and Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung (A-CC), Department of Radiology (F-CC), Department of Neurology Veterans General Hospital and National Yang-Ming University (C-PC, W-YS), Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung (H-YH), Department of Neurology, Taipei Medical University-Shaung Ho Hospital (LC), and Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University and Hospital (H-HH), Taipei, Taiwan.
authors.forename: Ke
authors.initials: K
authors.lastname: Han
authors.forename: A-Ching
authors.initials: AC
authors.lastname: Chao
authors.forename: Feng-Chi
authors.initials: FC
authors.lastname: Chang
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Hsu
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Chung
authors.forename: Wen-Yung
authors.initials: WY
authors.lastname: Sheng
authors.forename: Lung
authors.initials: L
authors.lastname: Chan
authors.forename: Jiang
authors.initials: J
authors.lastname: Wu
authors.forename: Han-Hwa
authors.initials: HH
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D020757:Amaurosis Fugax / Q000175:diagnosis* / Q000503:physiopathology; D020236:Amnesia, Transient Global / Q000175:diagnosis* / Q000503:physiopathology; D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging / Q000473:pathology; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis* / Q000503:physiopathology; D010690:Phlebography / Q000379:methods*; D012189:Retrospective Studies; D013624:Taiwan; D054064:Transverse Sinuses / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014654:Vascular Patency