title: The manifestation of vortical and secondary flow in the cerebral venous outflow tract: An in vivo MR velocimetry study.
abstract: Aberrations in flow in the cerebral venous outflow tract (CVOT) have been implicated as the cause of several pathologic conditions including idiopathic intracranial hypertension (IIH), multiple sclerosis (MS), and pulsatile tinnitus (PT). The advent of 4D flow magnetic resonance imaging (4D-flow MRI) has recently allowed researchers to evaluate blood flow patterns in the arterial structures with great success. We utilized similar imaging techniques and found several distinct flow characteristics in the CVOT of subjects with and without lumenal irregularities. We present the flow patterns of 8 out of 38 subjects who have varying heights of the internal jugular bulb and varying lumenal irregularities including stenosis and diverticulum. In the internal jugular vein (IJV) with an elevated jugular bulb (JB), 4Dflow MRI revealed a characteristic spiral flow that was dependent on the level of JB elevation. Vortical flow was also observed in the diverticula of the venous sinuses and IJV. The diversity of flow complexity in the CVOT illustrates the potential importance of hemodynamic investigations in elucidating venous pathologies.
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kefayati
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Amans
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: Farshid
authors.initials: F
authors.lastname: Faraji
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Ballweber
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: Evan
authors.initials: E
authors.lastname: Kao
authors.affiliation: Siemens Healthcare, CA, USA.
authors.forename: Sinyeob
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Department of Neurology, UCSF, San Francisco, CA, USA.
authors.forename: Karl
authors.initials: K
authors.lastname: Meisel
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: Van
authors.initials: V
authors.lastname: Halbach
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA; Radiology Service, VA Medical Center, San Francisco, USA.
authors.forename: David
authors.initials: D
authors.lastname: Saloner
mesh_terms: D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000502:physiology*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D012039:Regional Blood Flow
keywords: 4D-flow MRI; Cerebral venous flow; Jugular vein; Pulsatile tinnitus; Vortical flow