Correlation Between Trans-Stenotic Blood Flow Velocity Differences and the Cerebral Venous Pressure Gradient in Transverse Sinus Stenosis: A Prospective 4-Dimensional Flow Magnetic Resonance Imaging Study. Issue 4 (25th June 2021)

• Record Type: Journal Article
• Authors: Ding, Heyu; Zhao, Pengfei; Lv, Han; Li, Xiaoshuai; Qiu, Xiaoyu; Zeng, Rong; Wang, Guopeng; Yang, Zhenghan; Gong, Shusheng; Jin, Long; Wang, Zhenchang
• Is Part Of: Neurosurgery. Volume 89:Issue 4(2021)
• Page Start: 549
• Page End: 556
• Publication Date: 2021-06-25
• Subjects: Blood flow velocity -- Venous pressure -- Hemodynamics -- Idiopathic intracranial hypertension -- Tinnitus -- Magnetic resonance imaging -- Manometry; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyab222
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: BACKGROUND: The relationship between trans-stenotic blood flow velocity differences and the cerebral venous pressure gradient (CVPG) in transverse sinus (TS) stenosis (TSS) has not been studied. OBJECTIVE: To evaluate the hemodynamic manifestations of TSS and the relationship between trans-stenotic blood flow velocity differences and the CVPG. METHODS: Thirty-three patients with idiopathic intracranial hypertension (IIH) or pulsatile tinnitus (PT) and TSS who had undergone diagnostic venography using venous manometry were included in the patient group. Thirty-three volunteers with no stenosis and symptoms were included in the control group. All the 2 groups underwent prospective venous sinus 4-dimensional (4D) flow magnetic resonance imaging (MRI). The average velocity (Vavg ) difference and maximum velocity (Vmax) difference between downstream and upstream of the TS in 2 groups were measured and compared. Correlations between the CVPG and trans-stenotic Vavg difference/Vmax difference/index of transverse sinus stenosis (ITSS) were assessed in the patient group. RESULTS: The differences in Vavg difference and Vmax difference between the patient and control groups showed a statistical significance ( P < .001). The Vavg difference and Vmax difference had a strong correlation with CVPG (R = 0.675 and 0.701, respectively, P < .001) in the patient group. Multivariate linear regression using the stepwise method showed that the Vmax difference and ITSS were correlated with the CVPG (R = 0.752 and R 2 = 0.537, respectively; P < .001). CONCLUSION: The trans-stenotic blood flow velocity difference significantly correlates with the CVPG in TSS. As a noninvasive imaging modality, 4D flow MRI may be a suitable screening or complimentary tool to decide which TSS may benefit from invasive venous manometry.