Article Figures & Data
Figures
- Fig 1.
Case of a 66-year-old woman.
A and B, Coronal 2D PC MR venograms obtained during regular breathing (A) and breath holding (B). The right sigmoid sinus is clearly depicted on the regular-breathing image. Signal intensity decreases with breath holding. The left transverse and sigmoid sinuses are not seen on the regular-breathing image. However, the signal intensities of these veins (arrows) are depicted on the breath-holding image.
C, Velocity image of the peripheral pulse–triggered 2D PC sequence shows the signal intensities of the sigmoid sinuses. The signal intensity of the right sigmoid sinus decreases during breath holding. However, increased signal intensity is observed in the left sigmoid sinus with breath holding, compared with regular breathing. These flow changes of the sinuses are consistent with the results on the MR venograms. ○ indicates the right sigmoid sinus (regular breathing); •, the right sigmoid sinus (breath holding); □, the left sigmoid sinus (regular breathing); ▪, the left sigmoid sinus (breath holding).
- Fig 2.
Case of a 63-year-old man.
A and B, Coronal 2D PC MR venogram with regular breathing (A) and breathholding (B). Right transverse and sigmoid sinuses are seen on both regular-breathing and breath-holding images. The left sigmoid sinus is not visualized on regular-breathing image, but is seen on the breath-holding image (arrow).
C, Velocity image shows signal intensities of sigmoid sinuses. The signal intensity of the right sigmoid sinus decreases slightly during breath holding. The signal intensity of the left sigmoid sinus with regular breathing is below zero, which indicates retrograde flow. With breath holding, the retrograde flow is normalized, but the signal intensities are small, indicating slow flow. ○ indicates the right sigmoid sinus (regular breathing); •, the right sigmoid sinus (breath holding); ▪, the left sigmoid sinus (regular breathing); ▪, the left sigmoid sinus (breath holding).
D, Three-dimensional time-of-flight MR angiogram. The left internal jugular and sigmoid sinuses are seen on the maximum intensity projection image (arrow). Visualization of these veins can be explained by the in-flow effect of retrograde flow.
- Fig 3.
Average flow signal intensity in all subjects. Breath holding decreases the sinus flow in both sides. * indicates statistically significant difference (P < .05). Bars indicate standard deviation; RB, regular breathing; BH, breath holding
- Fig 4.
Diagram illustrates the physiologic venous stenosis at the thoracic inlet.
A, The left brachiocephalic vein (Bv) is compressed between the aortic arch (Ao) and the sternum (St) during regular breathing (arrowheads).
B, The compression is relieved by full inspiration (arrowheads), because the distance between the aorta and sternum increases due to the elevation of anterior chest wall (arrows). E indicates esophagus; Sv, superior vena cava; T, trachea; V, vertebra
- Fig 5.
Venous stasis mimicking sinus thrombosis in a patient with systemic lupus erythematosus.
A, Axial fast fluid-attenuated inversion-recovery image (9000/110/2300/1 [TR/TE/TI/excitation]) shows high signal intensity in the left transverse sinus (arrowhead). Venous thrombosis is suspected.
B and C, Coronal 2D PC MR venograms. Although the left transverse and sigmoid sinuses are not visible on the regular-breathing image (B), these veins are clearly depicted on the breath-holding image (arrows in C). Venous occlusion is ruled out by MR venography with breath holding.
- Fig 6.
Case of a 53-year-old man with venous sinus thrombosis.
A, Axial fast spin-echo T2-weighted image (4500/106/2 [TR/TE/excitations]) shows inhomogeneous high and low signal intensity in the right transverse sinus (arrowheads).
B and C, Coronal 2D PC MR venograms show partial defect in the right transverse sinus and sigmoid sinus on the regular-breathing image (B). The right internal jugular vein is not seen. These defects do not change on the breath-holding image (C).
D, Anteroposterior venous phase image of right carotid angiography shows filling defect in the right transverse and sigmoid sinuses.
Tables
Readers Right sigmoid sinus Left sigmoid sinus A and B 0.58 0.60 A and C 0.68 0.72 B and C 0.75 0.82 Average 0.67 0.71 RB < BH RB = BH RB > BH Total Right 12 38 57 107 Left 33 38 36 107 Data represent the number of patients.
(RB, regular breathing; BH, breath-holding)
Regular breathing Breath-holding Antegrade flow Retrograde flow Antegrade flow Retrograde flow Right 107 0 107 0 Left 103 4 107 0 RB < BH RB > BH Total Right 15 92 107 Left 37 70 107 Data show the number of patients.
(RB, regular breathing; BH, breath-holding)
- TABLE 5:
Correlation between signal change of MRV and velocity change of flow analysis (right sigmoid sinus)
MR venography Total RB < BH RB >= BH Flow Analysis RB < BH 4 11 15 RB > BH 8 84 92 Total 12 95 107 Data represent the number of patients.
(RB, regular breathing; BH, breath-holding)
- TABLE 6:
Correlation between signal change of MRV and velocity change of flow analysis (left sigmoid sinus)
MR venography Total RB < BH RB >= BH Flow Analysis RB < BH 22 15 37 RB > BH 11 59 70 Total 33 74 107 Data represent the number of patients.
(RB, regular breathing; BH, breath-holding)
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