The Mechanisms Of Human Cerebral Superficial Veins To Morpholog Changes On The Increased ICP

Purpose: 1 To confirm that special structure between the superior sagittalis sinus (SSS) and superficial veins which had been detected in the Danish Yorkshire landrace pigs is also in the human.2 By observing superficial veins' morpholog and the haemodynamic response of the increased ICP patients, to investigate the cerebral superficial veins' regulated mechanisms with the increased ICP.Methods: Classified 18 normal persons and 14 increased ICP patients with 3 groups, normal group (marked A), increased ICP group with no use of mannitol (marked B) and increased ICP group with mannitol used (marked C) . Length (L) and diameter (D) of the cerebral superficial veins were measured using TOF MRV technique. The definitions of diameter measurement points (Point C, Point B & Point b) were as follows: making the junction of the superficial vein and sagittal sinus as marking point, and dividing the whole distance of the superficial vein to 3 parts against the blood flow direction, then respectively they were, Point C—the junction of the cerebral superficial vein and sagittal sinus, Point B—the midpoint of Point C and developing extremity of the superficial vein, and Point b—the midpoint of Point C and Point B. The length measurement segment (L segment) is the distance between Point b and Point C. Image processed with the software ImageJ1.31.Results:1. The basic information of the developing: Total 28 patients have done TOF-MRV scans without contrast material. The image of 4 cases among all selected cannot attain the experiment request, and the MRV images of 10 buffers are used for statistics. The SSS is chosed to be a contradistinction. There is no obvious difference (P>0.05) between superficial vein in ICH and in normal. In medial layer, the average number of superficial vein in normal is 3.2, and 3.3 in ICH. In the normal group (Group A), there are no obvious difference ( P>0.05). In the experiment groups, the developing shows more obvious difference.2. The morphology parameters of the superficial veins in normal people: the average diameter of Point C chosen in the superficial vein in coronal position of normal group is 1.86 + 0.45mm, the average diameter of Point B is 2.21±0.52mm, and of Point b, there is 2.31±0.61mm. In anteroposterior position of normal group, there are 2.01 ±0.41mm. 2.01 ±0.48mm and 1.94 +0.48mm at Point C, Point b and Point B.3. The morphology parameters of the cerebral superficial vein in MRV coronal position in experimental group are: In Group B, the average diameter for Point C is 2.24±0.67mm, for Point b is 3.27±0.33mm, and 3.25 +0.76mm for Point B. In Group C, the average diameter of Point C, b and B are 2.12 + 0.59mm, 2.77 + 0.48mm, and 2.61+0.69mm.Conclusions:1. As a non-invasive technique, TOF-MRV can provide sufficient morphology information about intracranial venous system with its exact and rapid measurement and analysis.2. 36 superficial veins were chosen to be measured totally in normal group. We found that in coronal scan the diameter of Point B was longer than Point C (PO.001), also the diameter of Point b was longer than Point C (P<0.001), and there were noobvious differences in the average diameter between Point B and Point b (P>0.05). In anteroposterior scan, that showed no obvious differences in the diameter between Point C, Point B and Point b (P>0.05, P>0.05) . It suggest that a special morphology structure exists at the linkage place of the normal cerebral superficial vein and SSS through the analysis of the MRV coronal position pictures. Because of the characteristics of the special courser of the superficial veins, no obvious differences were observed in the anteroposterior position, and the anteroposterior position was not recommended to be used in the morphology measurement of the superficial veins.3. Compare the diameter of the same position of the increased ICP patients with the MRV technique. After the usage of mannitol the diameter changes have no obvious differences with the increased ICP state in the point C (P>0.05). With the same condition the comparison of the point B has the obvious statistical differences, and the point b has same result(P<0.05,P<0.05) .These results show with the environment of ICP changes the junction of the superficial veins and the SSS (point C) maybe has the special effect. When the ICP increases, there is not significant extension in diameter, but the other two points expand. It is implied that the junction of the superficial veins and the SSS has the valve function with the position of increased ICP. Then the study provides the morphology basis for the more hemodynamics investigation. In above, such conclusion can be obtained: When the ICP increases, the diameters of the superficial veins have the changes of expansion and the length extend. Then the vein blood capacity also increases. All these changes cause the vein blood siltation. As we all know the siltation will increase the intracranial blood capacity all the more. This will result in the infernal circle of the increased ICP.