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MRI and MR angiography findings to differentiate jugular venous reflux from cavernous dural arteriovenous fistula.
AJR Am J Roentgenol. 2014 Apr; 202(4):839-46.AA

Abstract

OBJECTIVE

Both jugular venous reflux (JVR) and cavernous dural arteriovenous fistula (DAVF) manifest as abnormal venous signal intensities on time-of-flight (TOF) MR angiography (MRA). We investigated brain MRI and MRA findings that might differentiate JVR from cavernous DAVF.

MATERIALS AND METHODS

Forty-one patients with abnormal venous signal intensities on TOF MRA in the cavernous sinus and its vicinity were selected from 1508 patients who had undergone TOF MRA over the previous 6 months. For comparison, the examinations of 26 patients with cavernous DAVF who had undergone imaging over the previous 8 years were collected. The following findings were assessed: the side and location of abnormal venous signal intensities on intracranial TOF MRA; the signal intensity of the proximal jugular vein on T2-weighted imaging; whether there was early opacification of the cavernous sinus in the arterial phase of contrast-enhanced MRA (CE-MRA); the side of jugular venous drainage in the arteriovenous phase of CE-MRA; and whether retrograde jugular venous flow was seen on neck TOF MRA.

RESULTS

Abnormal venous signal intensities were seen on the left side in 73% of patients with JVR and 58% of patients with cavernous DAVF; involvement of the cavernous sinus was found in 12% of patients with JVR and 100% of patients with cavernous DAVF. Increased signal intensity in the ipsilateral jugular vein on T2-weighted imaging was found in 73% of JVR patients and 4% of cavernous DAVF patients. Early opacification of the cavernous sinus in the arterial phase of CE-MRA, ipsilateral jugular venous drainage in the arteriovenous phase of CE-MRA, and ipsilateral retrograde jugular venous flow on neck TOF MRA were found in 0%, 0%, and 63%, respectively, of JVR patients and in 100%, 100%, and 0%, respectively, of cavernous DAVF patients.

CONCLUSION

JVR and cavernous DAVF can be differentiated from one another using MRI and MRA.

Authors+Show Affiliations

1 Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24660714

Citation

Kim, Eunhee, et al. "MRI and MR Angiography Findings to Differentiate Jugular Venous Reflux From Cavernous Dural Arteriovenous Fistula." AJR. American Journal of Roentgenology, vol. 202, no. 4, 2014, pp. 839-46.
Kim E, Kim JH, Choi BS, et al. MRI and MR angiography findings to differentiate jugular venous reflux from cavernous dural arteriovenous fistula. AJR Am J Roentgenol. 2014;202(4):839-46.
Kim, E., Kim, J. H., Choi, B. S., Jung, C., & Lee, D. H. (2014). MRI and MR angiography findings to differentiate jugular venous reflux from cavernous dural arteriovenous fistula. AJR. American Journal of Roentgenology, 202(4), 839-46. https://doi.org/10.2214/AJR.13.11048
Kim E, et al. MRI and MR Angiography Findings to Differentiate Jugular Venous Reflux From Cavernous Dural Arteriovenous Fistula. AJR Am J Roentgenol. 2014;202(4):839-46. PubMed PMID: 24660714.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - MRI and MR angiography findings to differentiate jugular venous reflux from cavernous dural arteriovenous fistula. AU - Kim,Eunhee, AU - Kim,Jae Hyoung, AU - Choi,Byung Se, AU - Jung,Cheolkyu, AU - Lee,Dong Hoon, PY - 2014/3/26/entrez PY - 2014/3/26/pubmed PY - 2014/5/21/medline SP - 839 EP - 46 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 202 IS - 4 N2 - OBJECTIVE: Both jugular venous reflux (JVR) and cavernous dural arteriovenous fistula (DAVF) manifest as abnormal venous signal intensities on time-of-flight (TOF) MR angiography (MRA). We investigated brain MRI and MRA findings that might differentiate JVR from cavernous DAVF. MATERIALS AND METHODS: Forty-one patients with abnormal venous signal intensities on TOF MRA in the cavernous sinus and its vicinity were selected from 1508 patients who had undergone TOF MRA over the previous 6 months. For comparison, the examinations of 26 patients with cavernous DAVF who had undergone imaging over the previous 8 years were collected. The following findings were assessed: the side and location of abnormal venous signal intensities on intracranial TOF MRA; the signal intensity of the proximal jugular vein on T2-weighted imaging; whether there was early opacification of the cavernous sinus in the arterial phase of contrast-enhanced MRA (CE-MRA); the side of jugular venous drainage in the arteriovenous phase of CE-MRA; and whether retrograde jugular venous flow was seen on neck TOF MRA. RESULTS: Abnormal venous signal intensities were seen on the left side in 73% of patients with JVR and 58% of patients with cavernous DAVF; involvement of the cavernous sinus was found in 12% of patients with JVR and 100% of patients with cavernous DAVF. Increased signal intensity in the ipsilateral jugular vein on T2-weighted imaging was found in 73% of JVR patients and 4% of cavernous DAVF patients. Early opacification of the cavernous sinus in the arterial phase of CE-MRA, ipsilateral jugular venous drainage in the arteriovenous phase of CE-MRA, and ipsilateral retrograde jugular venous flow on neck TOF MRA were found in 0%, 0%, and 63%, respectively, of JVR patients and in 100%, 100%, and 0%, respectively, of cavernous DAVF patients. CONCLUSION: JVR and cavernous DAVF can be differentiated from one another using MRI and MRA. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/24660714/MRI_and_MR_angiography_findings_to_differentiate_jugular_venous_reflux_from_cavernous_dural_arteriovenous_fistula_ L2 - https://www.ajronline.org/doi/10.2214/AJR.13.11048 DB - PRIME DP - Unbound Medicine ER -