Методы визуализации спонтанных венозных повреждений головного мозга и их применимость в хирургии опухолей основания черепа

Стремительно развивающиеся технологии нейровизуализации позволяют с точностью определить венозную ишемию и венозный инфаркт головного мозга. Большинство работ по данной тематике посвящено изучению спонтанных церебральных венозных тромбозов. Общим для подобных тромбозов и венозных повреждений, возникших в ходе удаления опухолей основания черепа, является острое выключение церебральных вен. Однако в остальных аспектах клинико-диагностические алгоритмы зачастую не аналогичны. В статье представлены обобщение и анализ доступной литературы о возможностях нейровизуализации венозных повреждений головного мозга в спонтанных и хирургических условиях. Описаны современные способы ангиографической и перфузионной диагностики на примере тромбоза дуральных синусов и кортикальных вен. Приведена дискуссия о возможности применения данных методик в нейрохирургии. 

1. Savardekar AR, Patra DP, Narayan V, et al. Incidence, pathophysiology, and prevention strategies for cerebral venous complications after neurologic surgery: a systematic review of the literature. World Neurosurg. 2018;119:294–299. https://doi.org/10.1016/j.wneu.2018.06.231

2. Lin N, Wong AK, Lipinski LJ, et al. Reversible changes in diffusion- and perfusion-based imaging in cerebral venous sinus thrombosis. J Neurointerv Surg. 2016;8(2):6. https://doi.org/10.1136/neurintsurg-2014-011447.rep.

3. Sadik JC, Jianu D, Sadik R, et al. Imaging of cerebral venous thrombosis. Life. 2022;12(8):1215. https://doi.org/10.3390/life12081215

4. Ulivi L, Squitieri M, Cohen H, et al. Cerebral venous thrombosis: a practical guide. Pract Neurol. 2020;20(5):356– 367. https://doi.org/10.1136/practneurol-2019-002415

5. Li AY, Tong E, Yedavalli VS. A case-based review of cerebral venous infarcts with perfusion imaging and comparison to arterial ischemic stroke. Front Radiol. 2021;1:687045. https://doi.org/10.3389/fradi.2021.687045

6. Makkat S, Stadnik T, Peeters E, et al. Pathogenesis of venous stroke: evaluation with diffusion- and perfusion-weighted MRI. J Stroke Cerebrovasc Dis. 2003;12(3):132– 136. https://doi.org/10.1016/S10523057(03)00039-9

7. Arnoux A, Triquenot-Bagan A, Andriuta D, et al. Imaging characteristics of venous parenchymal abnormalities. Stroke. 2017;48:3258–3265. https://doi.org/10.1161/STROKEAHA.117.017937

8. Röttger C, Trittmacher S, Gerriets T, et al. Reversible MR imaging abnormalities following cerebral venous thrombosis. AJNR Am J Neuroradiol. 2005;26(3):607–613.

9. Saposnik G, Bushnell C, Coutinho JM, et al. American heart association stroke council; council on cardiopulmonary, critical care, perioperative and resuscitation; council on cardiovascular and stroke nursing; and council on hypertension. Diagnosis and management of cerebral venous thrombosis: a scientific statement from the american heart association. Stroke. 2024;55(3):77–90. https://doi.org/10.1161/STR.0000000000000456

10. Xu W, Gao L, Li T, et al. The performance of CT versus MRI in the differential diagnosis of cerebral venous thrombosis. Thromb Haemost. 2018;118(6):1067– 1077. https://doi.org/10.1055/s-0038-1642636

11. Kawaguchi T, Kawano T, Kaneko Y, et al. Classification of venous ischaemia with MRI. J Clin Neurosci. 2001;8(1):82–88. https://doi.org/10.1054/jocn.2001.0884

12. Choi JE, Weon YC, Park GM, et al. Comparison of MRI sequences for the detection of cerebral venous sinus thrombosis during follow-up examination. J Korean Soc Radiol. 2018;78(5):330–339. https://doi.org/10.3348/jksr.2018.78.5.330

13. Halil E. CT perfusion — an up-to-date element of the contemporary multimodal diagnostic approach to acute ischemic stroke. Folia Med. 2023;65(4):531–538. https://doi.org/10.3897/folmed.65.e96954

14. Lui YW, Tang ER, Allmendinger AM, et al. Evaluation of CT perfusion in the setting of cerebral ischemia: patterns and pitfalls. AJNR Am J Neuroradiol. 2010;31(9):1552–1563. https://doi.org/10.3174/ajnr.A2026

15. Gupta RK, Bapuraj JR, Khandelwal N, et al. Prognostic indices for cerebral venous thrombosis on CT perfusion: a prospective study. Eur J Radiol. 2014;83(1):185– 190. https://doi.org/10.1016/j.ejrad.2013.09.027

16. Naik S, Phadke RV, Bhoi SK, et al. Perfusion mri in cerebral venous and sinus thrombosis. Neurol india. 2024;72(4):791–796. https://doi.org/10.4103/neurol-india. NI_485_20

17. Kang JH, Yun TJ, Yoo RE, et al. Bright sinus appearance on arterial spin labeling MR imaging aids to identify cerebral venous thrombosis. Medicine. 2017;96(41):8244. https://doi.org/10.1097/MD.0000000000008244

18. Furuya S, Kawabori M, Fujima N, et al. Serial arterial spin labeling may be useful in assessing the therapeutic course of cerebral venous thrombosis: case reports. Neurol Med Chir. 2017;57:557–561. https://doi.org/10.2176/nmc.cr.2017-0033

19. Alajmi E, Zung J, Duquet-Armand M, et al. Prevalence of venous infarction in patients with cerebral venous thrombosis: baseline diffusion-weighted MRI and follow-up MRI. Stroke. 2023;54(7):1808–1814. https://doi.org/10.1161/STROKEAHA.122.042336

20. Lv B, Jing F, Tian CL, et al. Diffusion-weighted magnetic resonance imaging in the diagnosis of cerebral venous thrombosis: a meta-analysis. J Korean Neurosurg Soc. 2021;64(3):418–426. https://doi.org/10.3340/jkns.2020.0247

21. Favrole P, Guichard JP, Crassard I, et al. Diffusion-weighted imaging of intravascular clots in cerebral venous thrombosis. Stroke. 2004;35:99–103. https://doi.org/10.1161/01.STR.0000106483.41458.AF

22. Yamashiro K, Wakako A, Omi T, et al. Evaluating diploic vein blood flow using time-resolved whole-head computed tomography angiography and determining the positional relationship between typical craniotomy approaches and diploic veins in patients with meningioma. Acta Neurochir. 2022;164(11):2999–3010.

23. Dean BL, Wallace RC, Zabramski JM, et al. Incidence of superficial sylvian vein compromise and postoperative effects on CT imaging after surgical clipping of middle cerebral artery aneurysms. Am J Neuroradiol. 2005; 26(8):2019–2026.

24. Sughrue ME, Rutkowski MJ, Shangari G, et al. Incidence, risk factors, and outcome of venous infarction after meningioma surgery in 705 patients. J Clin Neurosci. 2011;18(5):628–632. https://doi.org/10.1016/j.jocn.2010.10.001

25. Kaku S, Miyahara K, Fujitsu K, et al. Drainage pathway of the superior petrosal vein evaluated by CT venography in petroclival meningioma surgery. J Neurol Surg B Skull Base. 2012;73(5):316–320. https://doi.org/ 10.1055/s-0032-1321509

26. Narayan V, Savardekar AR, Patra DP, et al. Safety profile of superior petrosal vein (the vein of Dandy) sacrifice in neurosurgical procedures: a systematic review. Neurosurg Focus. 2018;45(1):3. https://doi.org/10.3171/2018.4.FOCUS18133

27. Cai Q, Wang S, Zheng M, et al. Risk factors influencing cerebral venous infarction after meningioma resection. BMC Neurol. 2022;22(1):259. https://doi.org/10.1186/s12883-022-02783-2

28. Wu Y, Tian Q, Wang S, et al. Hemorrhagic cerebral venous infarction after vein injury during intraoperative lesion resection: incidence, hemorrhagic stages, risk factors and prognosis. Front Neurol. 2024;15:1371184. https://doi.org/10.3389/fneur.2024.1371184