Takahashi Neurovascular Imaging

MRI & Microangiography
1. Auflage 2010
ISBN: 978-1-84882-134-7
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 515 Seiten

The comparison of MR images and cadaver microangiograms of the basal perforating arteries is crucial for understanding the courses and supply areas of these vessels and in turn, for diagnosing pathologies in this region. Divided into three sections- normal anatomy of brain vessels; neurovascular imaging in pathology; and anatomy and imaging of spinal vessels- Neurovascular Imaging contains a rich collection of images to teach the reader how to interpret MR images of the brain vessels and spinal vessels, and how to identify pathological signs. Written and edited by a group of highly acclaimed experts in the field, Neurovascular Imaging is an authoritative account of the interpretation of MR images of the brain vessels and spinal vessels, and is a valuable addition to the library of the diagnostic radiologist.

Shoki Takahashi, MD is Professor and Chair of the Department of Diagnostic Radiology at Tohoku University Graduate School of Medicine in Sendai, Japan.

Autoren/Hrsg.

Takahashi, Shoki

Inhaltsverzeichnis

1;Neurovascular Imaging;1
1.1;Preface;4
1.2;Contents;6
1.3;Contributors;8
1.4;Part I: Normal Anatomy of Brain Vessels;10
1.4.1;1: Intracranial Arterial System: The Main Trunks and Major Arteries of the Cerebrum;11
1.4.1.1;1.1 Introduction;11
1.4.1.2;1.2 Internal Carotid Artery (ICA);11
1.4.1.2.1;1.2.1 Segments of the ICA delineated by Bouthillier et al. (Fig. 1.2) [10, 23];12
1.4.1.2.2;1.2.2 The Ophthalmic Artery (Fig. 1.5);15
1.4.1.2.3;1.2.3 Anatomy and Aneurysms of the Paraclinoid Region;16
1.4.1.2.3.1;1.2.3.1 Anatomy of the Paraclinoid Region (Fig. 1.6);16
1.4.1.2.3.2;1.2.3.2 Paraclinoid Aneurysms;18
1.4.1.3;1.3 The Circle of Willis;20
1.4.1.4;1.4 The Main Arteries of the Cerebrum and Their Vascular Territories;24
1.4.1.4.1;1.4.1 The Main Arterial Trunks and Their Branches;24
1.4.1.4.2;1.4.2 The Vascular Territories of the Cerebral Arteries;24
1.4.1.4.3;1.4.3 The Boundary Zone and Leptomeningeal Anastomoses;27
1.4.1.4.4;1.4.4 Arterial Supply of the Uncus/Parahippocampal Gyrus and the Hippocampal Region;31
1.4.1.4.4.1;1.4.4.1 The Uncus/Parahippocampal Gyrus;32
1.4.1.4.4.2;1.4.4.2 The Hippocampus;34
1.4.1.4.4.2.1;Superficial (Leptomeningeal) Hippocampal Arteries;44
1.4.1.4.4.2.2;Intrahippocampal Arteries;49
1.4.1.4.4.2.3;Microangiograms of hippocampal arteries and MR images of infarction of hippocampal region;49
1.4.1.5;References;57
1.4.2;2: Intracranial Arterial System: Basal Perforating Arteries;60
1.4.2.1;2.1 Introduction;60
1.4.2.2;2.2 Striate Arterial Group;60
1.4.2.2.1;2.2.1 Medial Striate Arteries (MSA);60
1.4.2.2.2;2.2.2 Lenticulostriate Arteries;66
1.4.2.2.2.1;2.2.2.1 Origin, Course;66
1.4.2.2.2.2;2.2.2.2 Intracerebral Course and Distribution;70
1.4.2.2.2.3;2.2.2.3 Territories;70
1.4.2.2.3;2.2.3 Distribution of the Striate Arteries on Microangiograms;70
1.4.2.2.4;2.2.4 Imaging of Infarcts in the Distribution of Striate Arteries;74
1.4.2.3;2.3 Anterior Choroidal Artery and Carotid Branches;78
1.4.2.3.1;2.3.1 Anterior Choroidal Artery;78
1.4.2.3.1.1;2.3.1.1 Phylogenic Development;78
1.4.2.3.1.2;2.3.1.2 Origin and Segments;79
1.4.2.3.1.3;2.3.1.3 Branches, Distribution, and Microangiographic Findings;83
1.4.2.3.1.4;2.3.1.4 Subependymal Arteries (SEA);89
1.4.2.3.1.5;2.3.1.5 Clinical Features and Imaging Findings of Infarcts in the AChA Territory;91
1.4.2.3.1.6;Box 2.1 Does the anterior choroidal artery supply the paraventricular region?;92
1.4.2.3.2;2.3.2 Direct Perforators of the Internal Carotid Artery;93
1.4.2.4;2.4 Thalamic Arterial Group;97
1.4.2.4.1;2.4.1 Generalized Anatomy of the Vascular Supply of the Thalamus with Microangiographic Findings;97
1.4.2.4.2;2.4.2 Thalamotuberal Artery;99
1.4.2.4.3;2.4.3 Thalamoperforate Artery (TPA);102
1.4.2.4.4;2.4.4 Thalamogeniculate Artery (TGA);106
1.4.2.4.5;2.4.5 Medial Posterior Choroidal Artery;109
1.4.2.4.6;2.4.6 Lateral Posterior Choroidal Artery;114
1.4.2.4.7;2.4.7 Vascular Supply of the Choroid Plexus of the Lateral Ventricle;119
1.4.2.4.8;2.4.8 Vascular Supply of the Hypothalamus;120
1.4.2.5;2.5 Anastomoses Among the Perforating Arteries of the Brain;125
1.4.2.6;2.6 Vascular Supply of the Motor Pathway and MR Imaging;125
1.4.2.6.1;2.6.1 Vascular Supply of the Corona Radiata and the Posterior Limb of the Internal Capsule;125
1.4.2.6.2;2.6.2 MR Imaging of the Basal Perforators;126
1.4.2.7;References;132
1.4.3;3: Intracranial Arterial System: Infratentorial Arteries;138
1.4.3.1;3.1 Introduction;138
1.4.3.2;3.2 Vertebral Artery and Basilar Artery;138
1.4.3.3;3.3 Main Branches of the Vertebro-basilar System;143
1.4.3.3.1;3.3.1 Posterior Inferior Cerebellar Artery (PICA);143
1.4.3.3.2;3.3.2 Posterior Spinal Artery (PSA);145
1.4.3.3.3;3.3.3 Anterior Spinal Artery (ASA);146
1.4.3.3.4;3.3.4 Anterior Inferior Cerebellar Artery (AICA);146
1.4.3.3.5;3.3.5 Internal Auditory Artery;149
1.4.3.3.6;3.3.6 Superior Cerebellar Artery (SCA);149
1.4.3.4;3.4 Internal Vascular Supply of the Brainstem;150
1.4.3.4.1;3.4.1 Overview of Brainstem Vessels with Microangiographic Findings;150
1.4.3.4.2;3.4.2 Vascular Supply of the Medulla;152
1.4.3.4.2.1;3.4.2.1 The Anteromedial Group;152
1.4.3.4.2.2;3.4.2.2 The Anterolateral Group;154
1.4.3.4.2.3;3.4.2.3 The Lateral Group;161
1.4.3.4.2.4;3.4.2.4 The Posterior Group;161
1.4.3.4.3;3.4.3 Vascular Supply of the Pons;169
1.4.3.4.3.1;3.4.3.1 The Anteromedial Group;169
1.4.3.4.3.2;3.4.3.2 The Anterolateral Group;171
1.4.3.4.3.3;3.4.3.3 The Lateral Group;171
1.4.3.4.3.4;3.4.3.4 The Posterior Group;171
1.4.3.4.4;3.4.4 Vascular Supply of the Midbrain;172
1.4.3.4.4.1;3.4.4.1 Arteries that Encircle and Supply the Midbrain;172
1.4.3.4.4.2;3.4.4.2 The Anteromedial Group;172
1.4.3.4.4.3;3.4.4.3 The Anterolateral Group;176
1.4.3.4.4.4;3.4.4.4 The Lateral Group;176
1.4.3.4.4.5;3.4.4.5 The Posterior Group;176
1.4.3.4.4.6;3.4.4.6 Complementary Roles in the Vascularization of the Midbrain;180
1.4.3.5;3.5 Representative Imaging Findings in Cases with Infarcts in the Distribution of the Infratentorial Arteries (Figs. 3.26;180
1.4.3.6;References;194
1.4.4;4: Perforating Branches of the Anterior Communicating Artery: Anatomy and Infarction;196
1.4.4.1;4.1 The Anterior Communicating Artery (ACoA);196
1.4.4.2;4.2 Perforating Branches of the ACoA (Figs. 4.1 and 4.2);196
1.4.4.3;4.3 Infarcts in the Territory of the Perforating Branches of the ACoA;198
1.4.4.4;4.4 Structures Perfused Mainly by the Perforating Branches of the ACoA (Figs. 4.2 and 4.4);200
1.4.4.5;References;202
1.4.5;5: Cerebral Arterial Variations and Anomalies Diagnosed by MR Angiography;204
1.4.5.1;5.1 Introduction;204
1.4.5.2;5.2 Variations and Anomalies of the Common Carotid Artery (CCA) and Internal Carotid Artery (ICA);204
1.4.5.2.1;5.2.1 Brachiocephalic Trunk Origin of the Left CCA (Bovine Aortic Arch);204
1.4.5.2.2;5.2.2 Unusual Level of Bifurcation of the CCA, Absence of the CCA and Absence of the Proximal External Carotid Artery (ECA);205
1.4.5.2.3;5.2.3 Medial Origin and Retropharyngeal Course of the ICA;207
1.4.5.2.4;5.2.4Congenital Absence or Hypoplasia of the ICA;207
1.4.5.2.5;5.2.5 Aberrant Course of the ICA, Persistent Stapedial Artery;208
1.4.5.2.6;5.2.6 Fenestration of the ICA;212
1.4.5.2.7;5.2.7 Persistent Dorsal Ophthalmic Artery;213
1.4.5.3;5.3 Variations and Anomalies of the Anterior Cerebral Artery (ACA) and Anterior Communicating Artery;214
1.4.5.3.1;5.3.1 Carotid-ACA Anastomosis;214
1.4.5.3.2;5.3.2 Fenestration of the ACA and the Anterior Communicating Artery;215
1.4.5.3.3;5.3.3 Persistent Primitive Olfactory Artery;216
1.4.5.3.4;5.3.4 Azygos ACA, Bihemispheric ACA;218
1.4.5.3.5;5.3.5 Triple ACAs, Median Artery of the Corpus Callosum;218
1.4.5.4;5.4 Variations and Anomalies of the Middle Cerebral Artery (MCA);219
1.4.5.4.1;5.4.1 Duplicated MCA;219
1.4.5.4.2;5.4.2 Accessory MCA;219
1.4.5.4.3;5.4.3 Early Bifurcated MCA;221
1.4.5.4.4;5.4.4 Fenestration of the MCA;221
1.4.5.5;5.5 Variations and Anomalies of the Posterior Cerebral Artery (PCA);221
1.4.5.5.1;5.5.1 Duplicated PCA;221
1.4.5.5.2;5.5.2 PCA Branch Arising from the Hyperplastic Anterior Choroidal Artery;223
1.4.5.5.3;5.5.3 Fenestration of the PCA;223
1.4.5.6;5.6 Variations of the Circle of Willis;224
1.4.5.6.1;5.6.1 Unilateral Absence of A1 Segment;224
1.4.5.6.2;5.6.2 Unilateral or Bilateral Absence of P1 Segment;225
1.4.5.6.3;5.6.3 Unilateral or Bilateral Absence of the Posterior Communicating Artery;225
1.4.5.7;5.7 Variations and Anomalies of the Vertebrobasilar and Cerebellar Arteries;225
1.4.5.7.1;5.7.1 Variations of the Origin of the Vertebral Artery (VA);225
1.4.5.7.2;5.7.2 Anterior Course of the Proximal VA;226
1.4.5.7.3;5.7.3 Fenestration of the Extracranial VA, Persistent First Cervical Intersegmental Artery;226
1.4.5.7.4;5.7.4 Cervical Origin of the Posterior Inferior Cerebellar Artery (PICA);228
1.4.5.7.5;5.7.5 Fenestrations of the Intracranial Vertebrobasilar Arteries;228
1.4.5.7.6;5.7.6 Variations and Anomalies of the Cerebellar Arteries;232
1.4.5.8;5.8 Carotid-Vertebrobasilar Anastomoses;233
1.4.5.8.1;5.8.1 Proatlantal Artery Type 1 and Type 2;235
1.4.5.8.2;5.8.2 Persistent Hypoglossal Artery (PHA);237
1.4.5.8.3;5.8.3 Persistent Otic Artery?;237
1.4.5.8.4;5.8.4 Persistent Trigeminal Artery (PTA), Lateral Type;238
1.4.5.8.5;5.8.5 PTA, Medial Type;241
1.4.5.8.6;5.8.6 PTA Variants;241
1.4.5.9;References;243
1.4.6;6: Regional MR Perfusion Topographic Map of the Brain Using Arterial Spin Labeling at 3 Tesla;247
1.4.6.1;6.1 Introduction;247
1.4.6.2;6.2 Basic Principles of ASL and Regional Perfusion Imaging;247
1.4.6.2.1;6.2.1 Basic Principles of ASL;247
1.4.6.2.2;6.2.2 Regional Perfusion Imaging;249
1.4.6.3;6.3 Regional Perfusion Topographic Images in Normal and Pathological Cases;251
1.4.6.4;6.4 Conclusions;259
1.4.6.5;References;259
1.4.7;7: Normal Anatomy of Intracranial Veins: Demonstration with MR Angiography, 3D-CT Angiography and Microangiographic Injection S;260
1.4.7.1;7.1 Cranial Dural Venous Sinuses (Figs. 7.1–7.3);260
1.4.7.1.1;7.1.1 Superior Sinus Group;260
1.4.7.1.1.1;7.1.1.1 Superior Sagittal Sinus;260
1.4.7.1.1.2;7.1.1.2 Inferior Sagittal Sinus;263
1.4.7.1.1.3;7.1.1.3 Straight Sinus;264
1.4.7.1.1.4;7.1.1.4 Falcine Sinus (Fig. 7.7);264
1.4.7.1.1.5;7.1.1.5 Occipital Sinus (Fig. 7.8);265
1.4.7.1.1.6;7.1.1.6 Confluence of Sinuses;266
1.4.7.1.1.7;7.1.1.7 Transverse-Sigmoid Sinus;267
1.4.7.1.2;7.1.2 Inferior Sinus Group (Basal Sinus Group) (Fig. 7.3);268
1.4.7.1.2.1;7.1.2.1 Cavernous Sinus (Figs. 7.3 and 7.10);268
1.4.7.1.2.2;7.1.2.2 Superior Petrosal Sinus (Fig. 7.3);268
1.4.7.1.2.3;7.1.2.3 Inferior Petrosal Sinus (Fig. 7.10);269
1.4.7.1.2.4;7.1.2.4 Sphenoparietal Sinus (Fig. 7.3);269
1.4.7.1.2.5;7.1.2.5 Basilar Plexus (Fig. 7.3);269
1.4.7.1.2.6;7.1.2.6 Emissary Veins (Fig. 7.11);269
1.4.7.2;7.2 Cerebral and Cerebellar Veins;269
1.4.7.2.1;7.2.1 Supratentorial Veins;270
1.4.7.2.1.1;7.2.1.1 Superficial Cerebral Veins;270
1.4.7.2.1.1.1;Superior Cerebral Veins (Ascending Cortical Veins);270
1.4.7.2.1.1.2;Superficial Middle Cerebral Vein (Superficial Sylvian Vein) (Fig. 7.13);272
1.4.7.2.1.1.3;Inferior Cerebral Veins (Descending Cortical Veins) (Fig. 7.13);273
1.4.7.2.1.2;7.2.1.2 Parenchymal Veins;273
1.4.7.2.1.2.1;Superficial Parenchymal Veins (Superficial Draining Veins);273
1.4.7.2.1.2.2;Deep Parenchymal Veins (Deep Draining Veins of the White Matter);275
1.4.7.2.1.2.3;Transcerebral and Anastomotic Cerebral Veins;276
1.4.7.2.1.3;7.2.1.3 Deep Cerebral Veins Including the Vein of the Basal Ganglionic and Thalamic Regions;276
1.4.7.2.1.3.1;Tributaries of the Internal Cerebral Vein (Table 7.2, Fig. 7.18);277
1.4.7.2.1.3.2;Tributaries of the Basal Vein of Rosenthal (Fig. 7.19);279
1.4.7.2.1.3.3;Veins of the Basal Ganglionic Region (Fig. 7.20a, b);279
1.4.7.2.1.3.4;Veins of the Thalamic Region (Figs. 7.20c, d and 7.21);279
1.4.7.2.2;7.2.2 Infratentorial Veins (Veins of the Posterior Fossa) (Fig. 7.21);282
1.4.7.3;7.3 Veins of the Cranio-Vertebral Junction (Fig. 7.22);285
1.4.7.4;References;286
1.4.8;8: Mapping Superficial Cerebral Veins on the Brain Surface;289
1.4.8.1;8.1 Introduction;289
1.4.8.2;8.2 MR Imaging Techniques;289
1.4.8.2.1;8.2.1 Fusion Method;289
1.4.8.2.2;8.2.2 Rendering Method;292
1.4.8.3;References;296
1.5;Part II: Neurovascular Imagingin Pathology;297
1.5.1;9: Preoperative Visualization of the Lenticulostriate Arteries Associated with Insulo-Opercular Gliomas Using 3-T Magnetic Res;298
1.5.1.1;9.1 Introduction;298
1.5.1.2;9.2 Three-Dimensional MR Imaging;299
1.5.1.3;9.3 Representative Cases;299
1.5.1.3.1;9.3.1 Case 1;299
1.5.1.3.2;9.3.2 Case 2;302
1.5.1.4;9.4 Discussion;303
1.5.1.5;9.5 Conclusions;305
1.5.1.6;References;305
1.5.2;10: Ischemic Complications Associated with Resection of Opercular Gliomas;307
1.5.2.1;10.1 Introduction;307
1.5.2.2;10.2 Microangiographic Analysis of Vascular Supply to the Corona Radiata;307
1.5.2.3;10.3 MR Imaging Studies;308
1.5.2.4;10.4 Ischemic Complications Associated with Resection of Opercular Gliomas;310
1.5.2.4.1;10.4.1 Clinical Materials;310
1.5.2.4.2;10.4.2 Representative Cases;311
1.5.2.4.2.1;10.4.2.1 Case 1;311
1.5.2.4.2.2;10.4.2.2 Case 2;313
1.5.2.4.2.3;10.4.2.3 Case 3;315
1.5.2.5;10.5 Discussion;317
1.5.2.6;10.6 Conclusions;319
1.5.2.7;References;320
1.5.3;11: Imaging and Tissue Characterization of Atherosclerotic Carotid Plaque Using MR Imaging;321
1.5.3.1;11.1 Introduction;321
1.5.3.2;11.2 Histopathology of Carotid Plaque;321
1.5.3.3;11.3 Imaging of Carotid Plaque;324
1.5.3.3.1;11.3.1 Contrast Angiography;327
1.5.3.3.2;11.3.2 Computed Tomography;327
1.5.3.3.3;11.3.3 Ultrasonography;329
1.5.3.3.3.1;11.3.3.1 Surface Ultrasonography;329
1.5.3.3.3.2;11.3.3.2 Intravascular Ultrasonography;332
1.5.3.3.4;11.3.4 Magnetic Resonance Imaging;333
1.5.3.3.4.1;11.3.4.1 Hardware for MR Plaque Imaging;333
1.5.3.3.4.2;11.3.4.2 Approaches to MR Plaque Imaging;334
1.5.3.3.4.3;11.3.4.3 Interpretation of MR Plaque Imaging;335
1.5.3.3.4.4;11.3.4.4 Contrast Enhancement and Functional and Molecular Imaging for Carotid Plaque;339
1.5.3.3.4.5;11.3.4.5 Application to Treatment Strategies;341
1.5.3.4;11.4 Future Perspectives;342
1.5.3.5;References;342
1.5.4;12: MR Imaging of Cerebral Aneurysms;346
1.5.4.1;12.1 Saccular (Berry) Aneurysm;346
1.5.4.1.1;12.1.1 MR Imaging;351
1.5.4.1.2;12.1.2 MR Angiography;352
1.5.4.2;12.2 Dissection and Dissecting Aneurysm;356
1.5.4.2.1;12.2.1 MR Imaging;358
1.5.4.2.2;12.2.2 MR Angiography;359
1.5.4.3;12.3 Fusiform Aneurysm;365
1.5.4.3.1;12.3.1 MR Imaging and MR Angiography;365
1.5.4.4;12.4 Infectious Aneurysm;367
1.5.4.4.1;12.4.1 MR Imaging and MR Angiography;368
1.5.4.5;12.5 Traumatic Aneurysm;369
1.5.4.5.1;12.5.1 MR Imaging and MR Angiography;370
1.5.4.6;References;370
1.5.5;13: MR Imaging of Vascular Malformations;374
1.5.5.1;13.1 Arteriovenous Malformation (AVM);374
1.5.5.1.1;13.1.1 Clinical Overview;374
1.5.5.1.2;13.1.2 Characteristic Imaging Features and Diagnostic Points of AVM;375
1.5.5.1.2.1;13.1.2.1 Findings in Cases with and Without Bleeding;375
1.5.5.1.2.2;13.1.2.2MR Imaging Findings of AVM;375
1.5.5.1.2.2.1;AVM Grading System;376
1.5.5.1.2.2.2;Associated Aneurysms;377
1.5.5.1.2.2.3;Follow-Up Study After Treatment;377
1.5.5.1.3;13.1.3 Case of Arteriovenous Malformation (AVM);377
1.5.5.2;13.2 Dural Arteriovenous Fistula (dAVF);380
1.5.5.2.1;13.2.1 Definition and Overview;380
1.5.5.2.2;13.2.2 Classification and Treatment Strategies;381
1.5.5.2.2.1;13.2.2.1 Classification Systems;381
1.5.5.2.2.2;13.2.2.2 Treatment Options and Prognosis;381
1.5.5.2.3;13.2.3 Points and Characteristic Features of Diagnostic Imaging;382
1.5.5.2.3.1;13.2.3.1 Findings on Conventional Images;382
1.5.5.2.3.2;13.2.3.2 MRA and MRDSA for the Diagnosis of dAVF;382
1.5.5.2.4;13.2.4 Case of dAVF;383
1.5.5.3;13.3 Vein of Galen Malformation;383
1.5.5.3.1;13.3.1 Clinical Overview;383
1.5.5.3.2;13.3.2 Points of Diagnostic Imaging;384
1.5.5.3.3;13.3.3 Case of Vein of Galen Malformation;385
1.5.5.4;13.4 Cavernous Malformation;385
1.5.5.4.1;13.4.1 Clinical Overview;385
1.5.5.4.2;13.4.2 Points of Diagnostic Imaging;387
1.5.5.4.3;13.4.3 Case of Cavernous Malformation;387
1.5.5.5;13.5 Capillary Telangiectasia;389
1.5.5.5.1;13.5.1 Clinical Overview;389
1.5.5.5.2;13.5.2 Points of Diagnostic Imaging;389
1.5.5.5.3;13.5.3 Case of Capillary Telangiectasia;389
1.5.5.6;References;391
1.5.6; 14: Cerebral Venous Malformations;395
1.5.6.1;14.1 Classification of Cerebral Vascular Malformations;395
1.5.6.2;14.2 Terminology of Venous Malformations;395
1.5.6.3;14.3 Histology;396
1.5.6.4;14.4 Etiology;397
1.5.6.5;14.5 Symptoms and Treatment;397
1.5.6.6;14.6 Imaging;398
1.5.6.6.1;14.6.1 Angiographic (DSA) Findings with Consideration of the Pathomechanism of MVMs;398
1.5.6.6.2;14.6.2 CT Findings;400
1.5.6.6.3;14.6.3 MR Imaging;401
1.5.6.6.4;14.6.4 Radionuclide Study;406
1.5.6.7;References;407
1.5.7;15: Thrombosis of the Cerebral Veins and Dural Sinuses;409
1.5.7.1;15.1 Introduction;409
1.5.7.2;15.2 Symptoms and Pathogenesis;409
1.5.7.3;15.3 Imaging;411
1.5.7.3.1;15.3.1 Cranial CT;411
1.5.7.3.2;15.3.2CT Venography;416
1.5.7.3.3;15.3.3MR Imaging;417
1.5.7.3.4;15.3.4MR Venography;420
1.5.7.3.5;15.3.5Cerebral Angiography (DSA);420
1.5.7.4;15.4 CSVT Associated with Dural Arteriovenous Shunt (AVS);421
1.5.7.5;References;422
1.6;Part III: Anatomy and Imagingof Spinal Vessels;424
1.6.1;16: Vessels of the Spine and Spinal Cord: Normal Anatomy;425
1.6.1.1;16.1 Introduction;425
1.6.1.2;16.2 Arterial System;425
1.6.1.2.1;16.2.1 Design for the Development of Spinal Cord Arteries (Fig. 16.1);425
1.6.1.2.2;16.2.2 Spinal Arteries;427
1.6.1.2.3;16.2.3 Radicular Arteries;429
1.6.1.2.3.1;16.2.3.1 Classification;429
1.6.1.2.3.2;16.2.3.2 Radiculopial/Radiculomedullary Arteries and the Adamkiewicz Artery (AKA);430
1.6.1.2.4;16.2.4 Superficial Arteries of the Spinal Cord;431
1.6.1.2.4.1;16.2.4.1 Anterior Spinal Artery (ASA);433
1.6.1.2.4.2;16.2.4.2 Posterior Spinal Arteries;433
1.6.1.2.4.3;16.2.4.3 Pial Arterial Network (Vasocoronal Network);435
1.6.1.2.5;16.2.5 Intrinsic Arteries of the Spinal Cord;435
1.6.1.2.5.1;16.2.5.1 Sulcal (Central) Arteries;435
1.6.1.2.5.2;16.2.5.2 Peripheral System (Vasocorona);436
1.6.1.2.5.3;16.2.5.3 Distribution of the Arteries of the Spinal Cord (Fig. 16.12);436
1.6.1.3;16.3 Venous System;439
1.6.1.3.1;16.3.1 Spinal Cord Veins;439
1.6.1.3.1.1;16.3.1.1 Intraparenchymal Veins;440
1.6.1.3.1.2;16.3.1.2 Transmedullary Venous Anastomoses;440
1.6.1.3.1.3;16.3.1.3 Superficial Veins;442
1.6.1.3.2;16.3.2 Vertebral Venous Plexus (Batson’s Venous Plexus);442
1.6.1.3.3;16.3.3 Vein Valves and a System for Preventing Reflux;444
1.6.1.4;References;448
1.6.2;17: MDCT of the Artery of Adamkiewicz;449
1.6.2.1;17.1 Introduction;449
1.6.2.2;17.2 Computed Tomographic Imaging of the Artery of Adamkiewicz;450
1.6.2.2.1;17.2.1 Imaging Technique;450
1.6.2.2.2;17.2.2 Computed Tomography Protocol;450
1.6.2.2.3;17.2.3 Image Processing;454
1.6.2.2.4;17.2.4 Identification of the Artery of Adamkiewicz by MDCT;454
1.6.2.2.4.1;17.2.4.1 Detection of the Artery of Adamkiewicz;454
1.6.2.2.4.2;17.2.4.2 Differentiating the Spinal Artery and Vein;457
1.6.2.2.4.3;17.2.4.3 Visualization of the Artery of Adamkiewicz by MDCT with Intra-Arterial Contrast Injection;457
1.6.2.2.4.4;17.2.4.4 Rate of Detecting the Artery of Adamkiewicz by MDCT;458
1.6.2.2.4.5;17.2.4.5 Clinical Utility of Visualization of the Artery of Adamkiewicz by MDCT;458
1.6.2.2.4.5.1;Preoperative Visualization of the AKA Before Open Aortic Surgery;458
1.6.2.2.4.5.2;The AKA and Aortic Stent-Graft Insertion;458
1.6.2.2.4.6;17.2.4.6 Limitations of MDCT in Visualizing the Artery of Adamkiewicz;459
1.6.2.3;References;459
1.6.3;18: Magnetic Resonance Angiography of the Spinal Cord Blood Supply;462
1.6.3.1;18.1Introduction;462
1.6.3.2;18.2 Vascular anatomy;463
1.6.3.2.1;18.2.1 Spinal cord arteries;463
1.6.3.2.2;18.2.2 Spinal cord veins;464
1.6.3.3;18.3Clinical relevance;464
1.6.3.4;18.4 MR angiography;465
1.6.3.4.1;18.4.1 Imaging requirements;465
1.6.3.4.2;18.4.2 Image acquisition techniques;466
1.6.3.4.3;18.4.3 Image postprocessing and interpretation;470
1.6.3.4.4;18.4.4 Detection results;474
1.6.3.4.5;18.4.5 Clinical implementation of MR angiography;475
1.6.3.5;18.5 Outlook;480
1.6.3.6;18.6 Conclusions;481
1.6.3.7;References;481
1.6.4;19: Magnetic Resonance Imaging of Spinal Vascular Lesions;483
1.6.4.1;19.1 Introduction;483
1.6.4.2;19.2 Classification;483
1.6.4.3;19.3 Imaging Techniques;488
1.6.4.4;19.4 Characteristic Features of Common Spinal Vascular Lesions;490
1.6.4.4.1;19.4.1 Dural AVFs (Type I, Intradural Dorsal AVFs);490
1.6.4.4.1.1;19.4.1.1 Synonyms;490
1.6.4.4.1.2;19.4.1.2 General Issues;490
1.6.4.4.1.3;19.4.1.3 Clinical Presentation and Pathophysiology;490
1.6.4.4.1.4;19.4.1.4 MR Findings;492
1.6.4.4.2;19.4.2 Perimedullary AVFs (Type IV, Intradural Ventral AVFs);492
1.6.4.4.2.1;19.4.2.1 Synonyms;492
1.6.4.4.2.2;19.4.2.2 General Issues;492
1.6.4.4.2.3;19.4.2.3 Clinical Presentation and Pathophysiology;494
1.6.4.4.2.4;19.4.2.4 MR Findings;494
1.6.4.4.3;19.4.3 Intramedullary AVMs;498
1.6.4.4.3.1;19.4.3.1 Synonyms;498
1.6.4.4.3.2;19.4.3.2 General Issues;498
1.6.4.4.3.3;19.4.3.3 Clinical Presentation and Pathophysiology;498
1.6.4.4.3.4;19.4.3.4 MR Findings;499
1.6.4.5;References;501
1.6.5;Index;502
1.7;Index;502