Anatomical Variations of Cerebral MR Venography: Is Gender Matter?

Abstract

Purpose: Knowledge of variations in the cerebral dural venous sinus anatomy seen on magnetic resonance (MR) venography is essential to avoid over-diagnosis of cerebral venous sinus thrombosis (CVST). Very limited data is available on gender difference of the cerebral dural venous sinus anatomy variations.

Materials and methods: A retrospective study was conducted to study the normal anatomy of the intracranial venous system and its normal variation, as depicted by 3D MR venography, in normal adults and any gender-related differences.

Results: A total of 1654 patients (582 men, 1072 women, age range 19 to 86 years, mean age: 37.98±13.83 years) were included in the study. Most common indication for MR venography was headache (75.4%). Hypoplastic left transverse sinus was the most common anatomical variation in 352 (21.3%) patients. Left transverse sinus was hypoplastic in more commonly in male in comparison to female (24.9% versus 19.3%, p = 0.009). Most common variation of superior sagittal sinus (SSS) was atresia of anterior one third SSS (15, 0.9%). Except hypoplastic left transverse sinus, rest of anatomical variations of the transverse and other sinuses were not significantly differ among both genders.

Conclusion: Hypoplastic left transverse sinus is the most common anatomical variation and more common in male compared to female in the present study. Other anatomical variations of dural venous sinuses are not significantly differ among both genders.

Keywords: Cerebral venous anatomy; Cerebral venous sinus thrombosis; Magnetic resonance (MR) venography; Straight sinus; Superior sagittal sinus; Transverse sinus.

Fig. 1. A. Normal MRV including symmetrical transverse sinuses. B. Hypoplastic left transverse sinus and aplastic left sigmoid sinus (long thin arrow). C. Aplastic right transverse and sigmoid sinus (arrowheads). D. Hypoplastic right transverse sinus (thick arrowhead). E. Aplastic left transverse sinus (long thin arrow) and hypoplastic left sigmoid sinus. F. Aplastic anterior one third superior sagittal sinus (short thin arrows).