Intra- and Extracranial MR Venography: Technical Notes, Clinical Application, and Imaging Development.

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Scientific debate surrounds chronic cerebrospinal venous insufficiency (CCSVI) and its link to neurological conditions.
• Magnetic Resonance Venography (MRV) has advanced, offering better investigation of venous anatomy, patency, and flow.
• Existing MRV techniques require optimization for comprehensive intra- and extracranial venous system assessment.

Purpose of the Study:

• To propose a brief, two-tier MRI venography (MRV) protocol for evaluating intra- and extracranial venous drainage.
• To detail contrast-enhanced and non-contrast-enhanced MRV protocols for comprehensive venous system assessment.
• To establish the clinical feasibility of a rapid yet exhaustive MRV scan for various pathological conditions.

Main Methods:

• A two-tier MRV protocol: contrast-enhanced and non-contrast-enhanced.
• Contrast-enhanced protocol: time-resolved enhanced MRV and 2D Cine phase contrast (PC) for extracranial flow.
• Non-contrast-enhanced protocol: 3D PC, 2D time of flight (TOF), and 2D Cine PC for intracranial and extracranial flow.

Main Results:

• The contrast-enhanced protocol takes approximately seven minutes, including 2D Cine PC.
• The non-contrast-enhanced protocol takes approximately twenty minutes.
• Both protocols provide exhaustive assessment of the intra- and extracranial venous drainage system.

Conclusions:

• A concise, comprehensive MRV protocol for intra- and extracranial venous drainage is presented.
• This MRV approach is valuable for diagnosing neurological conditions with potential venous involvement.
• The proposed protocol offers a clinically practical solution for investigating venous system pathologies.