| Intravertebral venous plexus, also called Batson's vein, is one part of the vertebral venous system. It is located in the spinal epidural space and is the important vascular structure.The first anatomy study on the vertebral veins was reported by Breshet in 1800s. Batson was responsible for the revival of interest in the vertebral venous system. He demonstrated by injecting the dorsal vein of the penis, the anatomy of the internal vertebral venous plexus and epidural space, the relationships between the IWP and nervous roots, and the role in the spread of metastases.Neuroradiologic studies in 1960s and 70s demonstrate the vertebral venous system by catheterization of the ascending lumbar vein and femoral vein, to diagnose the herniated lumbar intervertebral disc. Recently, more and more literatures about IWP of MRI have been reported. But the low detectability of the lumbar venous plexuses and the incorrect measurement of AIVV was due to the series of MRI. MR venography has been used to examine the hepatic portal veins and hepatic veins. There are Gadolinium enhanced three - dimensional (3D) MR venography for spinal vascular malformations and 2D MRV for lumbar venous plexuses. The study was performed to evaluate the advantage of Gadolinium - enhanced 3D MRV and to establish criteria for the normal appearance of the IWP. To discuss the method of width of lumbar anterior internal vertebral vein (AIVV) with MRI andestablish the width range in normal persons. The aim is to detect Gd -DTPA enhancement patterns of the SEVP in the lumbar spinal columns of normal subjects and in patients with spinal abnormalities.Materials and MethodsFrom 2000.10 -2002.3, MRV was performed on the lumbars of 89 patients in the First Affiliated Clinical Hospital of China Medical University. There were fifty four males and thirty five females. The patients'mean age was 45 years, range 12-80 years, and there are 62 healthy volunteers. Lumbar spine examination of 27 patients was involved, including 15 lumbar disc herniation, 4 lumbar metastases,4 intradural tumor , 1 Budd - Chiari Syndrome, 2 tuberculosis of lumbar and 1 right kidney huge tumor with in inferior vena cava obstruction.All images were obtained by using a 1. 5 Tesla superconducting magnet( VISART TOSHIBA) and a 12 - cm - diameter circular planar surface coil operated in the receive mode. Routine T1WI,T2WI in sagittal planes and T2WIs in Axial planes were performed before contrast.The postcontrast images were obtained after bolus injection of Magnevist(0. 2mmol/kg) from cubital vein with injection rated 3ml/s and lasting 10-20 seconds. 2ml contrast was injected at first and the dynamic analysis of 2DFFE was performed. Peak transit of epidural venous system and scan delay time was estimated, then coronal 3DFFE protocol was used with TR = 12 TE = 5, flip angle 30, one NEX, a matrix of 192 x256 and 1mm slice thickness, 28 ~33cm field of view and 20 ~28 slices, interleave. Fat saturation was used. Each slice of the resulting venous data set was analyzed and subsequendy processed by MIP technique.The width of veins was measured at workstation ( software ALAT-VIEW1. 21), in the patients whose veins were all be seen.Image analysis (1) The healthy volunteers were categorized by age into two groups: 28 persons, younger than 40 years, and 34 persons, older than 40 years. The MRV images were assessed by two radiologists in consultation, then software SAS was used to evaluate the detectability of the lumbar venous plexuses between two groups. (2) The patients whose veins were all shown were divided into two groups respectively by age and sex. For statistical analysis of groups we used the student's t test. (3) MRV appearance of the patients were analyzed.ResultThe results for the volunteers showed that the detectability had remarkable difference except for RCAV of LI and L2 between the groups of younger and older than 40 years ( P < 0. 05 ). Of the 62 healthy volunteers, 42 persons showed all the veins, including 22 males and 20 females. It was not corr...
|
PDF Full Text Request