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Hyeyoung Choi - One of the best experts on this subject based on the ideXlab platform.
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pseudopathologic vertebral body enhancement in the presence of superior vena cava obstruction on computed tomography
The Spine Journal, 2015Co-Authors: Yoon Kyung Kim, Yon Mi Sung, Kyung Hoon Hwang, Eun Kyung Cho, Hyeyoung ChoiAbstract:Abstract Background context Superior vena cava (SVC) obstruction can cause the development of collateral vessels. During contrast-enhanced thoracic computed tomography (CT), contrast material may reflux into the collaterals such as paravertebral Venous Plexus. However, an unusual pseudopathologic vertebral body enhancement on CT in the presence of SVC obstruction has not been studied previously. Purpose To demonstrate clinical presentation and imaging findings of pseudopathologic vertebral body enhancement in patients with SVC obstruction. Study design Retrospective study of diagnostic CT images examined at our clinic. Patient sample From March, 2009 to September, 2012, a retrospective radiologic database review was performed to identify patients with obstruction of SVC causing contrast reflux into collateral vessels and presented with an unusual vertebral body enhancement on thoracic CT. Thirteen patients (11 men, mean age 51.4 years) with vertebral body enhancement were enrolled. Outcome measures Enhancement patterns of vertebral bodies were classified as nodular enhancement with round shape occupying less than one-third of vertebral body or polygonal enhancement occupying greater than or equal to one-third of vertebral body on axial image. The locations of enhanced areas within vertebral bodies were described using right lateral/central/left lateral, anterior/posterior, and upper/middle/lower in the x-, y-, or z-axis directions, respectively. Materials and methods Enhancement patterns, locations, and the presence of a connection between vertebral body enhancement and the paravertebral Venous Plexus were evaluated. Results A total of 39 vertebral body enhancements were found in the 13 patients, involving cervical (n=12), thoracic (n=25), or lumbar (n=2) vertebrae. Vertebral body enhancements showed a nodular (n=19) or a polygonal (n=20) pattern. The central portions of vertebral bodies were more frequently involved. The connection to the paravertebral Venous Plexus was observed in 34 lesions (87.2%). Conclusions Patients with SVC obstruction with extensive collateral vessels might exhibit a pseudopathologic vertebral enhancement. They tended to involve the central portion of the vertebral body, and most of them showed connection to the paravertebral Venous Plexus.
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pseudopathologic vertebral body enhancement in the presence of superior vena cava obstruction on computed tomography
The Spine Journal, 2015Co-Authors: Yon Mi Sung, Kyung Hoon Hwang, Hyeyoung ChoiAbstract:Abstract Background context Superior vena cava (SVC) obstruction can cause the development of collateral vessels. During contrast-enhanced thoracic computed tomography (CT), contrast material may reflux into the collaterals such as paravertebral Venous Plexus. However, an unusual pseudopathologic vertebral body enhancement on CT in the presence of SVC obstruction has not been studied previously. Purpose To demonstrate clinical presentation and imaging findings of pseudopathologic vertebral body enhancement in patients with SVC obstruction. Study design Retrospective study of diagnostic CT images examined at our clinic. Patient sample From March, 2009 to September, 2012, a retrospective radiologic database review was performed to identify patients with obstruction of SVC causing contrast reflux into collateral vessels and presented with an unusual vertebral body enhancement on thoracic CT. Thirteen patients (11 men, mean age 51.4 years) with vertebral body enhancement were enrolled. Outcome measures Enhancement patterns of vertebral bodies were classified as nodular enhancement with round shape occupying less than one-third of vertebral body or polygonal enhancement occupying greater than or equal to one-third of vertebral body on axial image. The locations of enhanced areas within vertebral bodies were described using right lateral/central/left lateral, anterior/posterior, and upper/middle/lower in the x-, y-, or z-axis directions, respectively. Materials and methods Enhancement patterns, locations, and the presence of a connection between vertebral body enhancement and the paravertebral Venous Plexus were evaluated. Results A total of 39 vertebral body enhancements were found in the 13 patients, involving cervical (n=12), thoracic (n=25), or lumbar (n=2) vertebrae. Vertebral body enhancements showed a nodular (n=19) or a polygonal (n=20) pattern. The central portions of vertebral bodies were more frequently involved. The connection to the paravertebral Venous Plexus was observed in 34 lesions (87.2%). Conclusions Patients with SVC obstruction with extensive collateral vessels might exhibit a pseudopathologic vertebral enhancement. They tended to involve the central portion of the vertebral body, and most of them showed connection to the paravertebral Venous Plexus.
Yon Mi Sung - One of the best experts on this subject based on the ideXlab platform.
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pseudopathologic vertebral body enhancement in the presence of superior vena cava obstruction on computed tomography
The Spine Journal, 2015Co-Authors: Yoon Kyung Kim, Yon Mi Sung, Kyung Hoon Hwang, Eun Kyung Cho, Hyeyoung ChoiAbstract:Abstract Background context Superior vena cava (SVC) obstruction can cause the development of collateral vessels. During contrast-enhanced thoracic computed tomography (CT), contrast material may reflux into the collaterals such as paravertebral Venous Plexus. However, an unusual pseudopathologic vertebral body enhancement on CT in the presence of SVC obstruction has not been studied previously. Purpose To demonstrate clinical presentation and imaging findings of pseudopathologic vertebral body enhancement in patients with SVC obstruction. Study design Retrospective study of diagnostic CT images examined at our clinic. Patient sample From March, 2009 to September, 2012, a retrospective radiologic database review was performed to identify patients with obstruction of SVC causing contrast reflux into collateral vessels and presented with an unusual vertebral body enhancement on thoracic CT. Thirteen patients (11 men, mean age 51.4 years) with vertebral body enhancement were enrolled. Outcome measures Enhancement patterns of vertebral bodies were classified as nodular enhancement with round shape occupying less than one-third of vertebral body or polygonal enhancement occupying greater than or equal to one-third of vertebral body on axial image. The locations of enhanced areas within vertebral bodies were described using right lateral/central/left lateral, anterior/posterior, and upper/middle/lower in the x-, y-, or z-axis directions, respectively. Materials and methods Enhancement patterns, locations, and the presence of a connection between vertebral body enhancement and the paravertebral Venous Plexus were evaluated. Results A total of 39 vertebral body enhancements were found in the 13 patients, involving cervical (n=12), thoracic (n=25), or lumbar (n=2) vertebrae. Vertebral body enhancements showed a nodular (n=19) or a polygonal (n=20) pattern. The central portions of vertebral bodies were more frequently involved. The connection to the paravertebral Venous Plexus was observed in 34 lesions (87.2%). Conclusions Patients with SVC obstruction with extensive collateral vessels might exhibit a pseudopathologic vertebral enhancement. They tended to involve the central portion of the vertebral body, and most of them showed connection to the paravertebral Venous Plexus.
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pseudopathologic vertebral body enhancement in the presence of superior vena cava obstruction on computed tomography
The Spine Journal, 2015Co-Authors: Yon Mi Sung, Kyung Hoon Hwang, Hyeyoung ChoiAbstract:Abstract Background context Superior vena cava (SVC) obstruction can cause the development of collateral vessels. During contrast-enhanced thoracic computed tomography (CT), contrast material may reflux into the collaterals such as paravertebral Venous Plexus. However, an unusual pseudopathologic vertebral body enhancement on CT in the presence of SVC obstruction has not been studied previously. Purpose To demonstrate clinical presentation and imaging findings of pseudopathologic vertebral body enhancement in patients with SVC obstruction. Study design Retrospective study of diagnostic CT images examined at our clinic. Patient sample From March, 2009 to September, 2012, a retrospective radiologic database review was performed to identify patients with obstruction of SVC causing contrast reflux into collateral vessels and presented with an unusual vertebral body enhancement on thoracic CT. Thirteen patients (11 men, mean age 51.4 years) with vertebral body enhancement were enrolled. Outcome measures Enhancement patterns of vertebral bodies were classified as nodular enhancement with round shape occupying less than one-third of vertebral body or polygonal enhancement occupying greater than or equal to one-third of vertebral body on axial image. The locations of enhanced areas within vertebral bodies were described using right lateral/central/left lateral, anterior/posterior, and upper/middle/lower in the x-, y-, or z-axis directions, respectively. Materials and methods Enhancement patterns, locations, and the presence of a connection between vertebral body enhancement and the paravertebral Venous Plexus were evaluated. Results A total of 39 vertebral body enhancements were found in the 13 patients, involving cervical (n=12), thoracic (n=25), or lumbar (n=2) vertebrae. Vertebral body enhancements showed a nodular (n=19) or a polygonal (n=20) pattern. The central portions of vertebral bodies were more frequently involved. The connection to the paravertebral Venous Plexus was observed in 34 lesions (87.2%). Conclusions Patients with SVC obstruction with extensive collateral vessels might exhibit a pseudopathologic vertebral enhancement. They tended to involve the central portion of the vertebral body, and most of them showed connection to the paravertebral Venous Plexus.
Ian Adatia - One of the best experts on this subject based on the ideXlab platform.
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angiographic findings of persistent primitive hepatic Venous Plexus with underdevelopment of the infrahepatic inferior vena cava in pediatric patients
American Journal of Roentgenology, 2000Co-Authors: Cathy Macdonald, Haverj Mikhailian, Shijoon Yoo, Robert M Freedom, Ian AdatiaAbstract:OBJECTIVE. We describe the angiographic diagnosis and significance of persistence of the primitive hepatic Venous Plexus with underdevelopment of the infrahepatic inferior vena cava.CONCLUSION. We recommend that inferior venacavography be performed in routine assessment before surgery of patients with azygos or hemiazygos continuation of the inferior vena cava, in whom redirection of systemic Venous blood to the pulmonary artery is contemplated.
Rob J M Groen - One of the best experts on this subject based on the ideXlab platform.
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the posterior intercostal vein a thermoregulatory gateway to the internal vertebral Venous Plexus
Clinical Anatomy, 2013Co-Authors: P V J M Hoogland, Quenton Wessels, W Vorster, Rob J M Groen, R Wettstein, L M Greyling, Sanet H KotzeAbstract:The internal vertebral Venous Plexus (IVVP) plays a putative role in thermoregulation of the spinal cord. Cold cutaneous Venous blood may cool, while warm Venous blood from muscles and brown fat areas may warm the spinal cord. The regulating mechanisms for both cooling and warming are still unknown. Warm Venous blood mainly enters the IVVP via the intervertebral veins. In the thoracic area these veins are connected to the posterior intercostal veins. In this study, anatomical structures were investigated that might support the mechanisms by which warmed Venous blood from the intercostal muscles and the recently described paravertebral patches of brown adipose tissue are able to drain into the vertebral Venous Plexus. Therefore, tissue samples from human cadavers (n = 21) containing the posterior intercostal vein and its connections to the IVVP and the azygos veins were removed and processed for histology. Serial sections revealed that the proximal parts of the posterior intercostal veins contained abundant smooth muscle fibers at their opening into the azygos vein. Furthermore, the walls of the proximal parts of the posterior intercostal veins contain plicae that allow the vessel to dilate, thereby allowing it to serve as a pressure chamber. It is suggested that a cold induced closure of the intercostal/azygos opening can result in retrograde blood flow from the proximal posterior intercostal vein towards the IVVP. This blood flow would be composed of warm blood from the paravertebral brown adipose tissue and blood containing metabolic heat from the muscles draining into the intercostal veins.
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the posterior intercostal vein a thermoregulatory gateway to the internal vertebral Venous Plexus
Clinical Anatomy, 2013Co-Authors: P V J M Hoogland, Quenton Wessels, W Vorster, Rob J M Groen, R Wettstein, L M Greyling, Sanet H KotzeAbstract:The internal vertebral Venous Plexus (IVVP) plays a putative role in thermoregulation of the spinal cord. Cold cutaneous Venous blood may cool, while warm Venous blood from muscles and brown fat areas may warm the spinal cord. The regulating mechanisms for both cooling and warming are still unknown. Warm Venous blood mainly enters the IVVP via the intervertebral veins. In the thoracic area these veins are connected to the posterior intercostal veins. In this study, anatomical structures were investigated that might support the mechanisms by which warmed Venous blood from the intercostal muscles and the recently described paravertebral patches of brown adipose tissue are able to drain into the vertebral Venous Plexus. Therefore, tissue samples from human cadavers (n=21) containing the posterior intercostal vein and its connections to the IVVP and the azygos veins were removed and processed for histology. Serial sections revealed that the proximal parts of the posterior intercostal veins contained abundant smooth muscle fibers at their opening into the azygos vein. Furthermore, the walls of the proximal parts of the posterior intercostal veins contain plicae that allow the vessel to dilate, thereby allowing it to serve as a pressure chamber. It is suggested that a cold induced closure of the intercostal/azygos opening can result in retrograde blood flow from the proximal posterior intercostal vein towards the IVVP. This blood flow would be composed of warm blood from the paravertebral brown adipose tissue and blood containing metabolic heat from the muscles draining into the intercostal veins. Clin. Anat. 26:735-740, 2013. (c) 2013 Wiley Periodicals, Inc.
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transient cauda equina compression syndrome and headache caused by internal vertebral Venous Plexus engorgement in a teenage female with vena cava inferior agenesis and iliac vein thrombosis
Journal of Neurology Neurosurgery and Psychiatry, 2007Co-Authors: D L M Oterdoom, P V J M Hoogland, B M De Jong, Rob J M GroenAbstract:The internal vertebral Venous Plexus (IVVP) is part of the vertebral Venous system (VVS). This system is the main alternative Venous pathway, which joins, parallels but at the same time bypasses the caval Venous system. The clinical relevance of the VVS is underestimated. We report on a patient who presented with cauda equina compression syndrome that was caused by engorgement of the IVVP. IVVP engorgement resulted from bilateral iliac vein thrombosis for which congenital agenesis of the inferior vena cava (IVC) was diagnosed as the predisposing factor. A 17-year-old female, with an unremarkable medical history, was referred to our hospital. She had suffered progressive lower back pain for 14 days and a cramp-like burning sensation in her left leg for 11 days. In addition, she had paroxysmal paresthesias in both feet. On the day of referral she was unable to walk because of diffuse non-radicular pain and weakness in both legs which developed within seconds after standing up. In this position, she also suffered from severe headache and vomiting. Physical examination revealed a body temperature of 37.6°C. Both inguinal fossae were tender to palpation. Neurological examination, including fundoscopy, was unremarkable. Laboratory tests revealed elevated C reactive protein (233 mg/ml (normal <4 mg/ml)), leucocytes (8.9×109/l (normal 4.0–10.0 …
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morphology of the human internal vertebral Venous Plexus a cadaver study after intraVenous araldite cy 221 injection
Anatomical Record-advances in Integrative Anatomy and Evolutionary Biology, 1997Co-Authors: Rob J M Groen, H J Groenewegen, H A M Van Alphen, Piet V HooglandAbstract:Reviewing the literature on the vascular anatomy of the spinal epidural space, it appeared that the knowledge of the internal vertebral Venous Plexus is limited. Injection studies of the entire internal vertebral Venous Plexus after application of modern techniques, to the best of our knowledge, have never been performed. Based on the clinical importance of these structures, it was decided to study the human vertebral Venous system after Araldite CY 221 injection, in order to update the morphological characteristics of the internal vertebral Venous system. The vertebral Venous systems of ten fresh human cadavers, between 64 and 93 years of age, were injected with Araldite CY 221 mixture. All cadavers were dissected and the posterior and anterior internal vertebral Venous Plexuses were studied in detail. The anterior part of the internal vertebral Venous Plexus is fairly constant. On the contrary, the posterior internal vertebral Venous Plexus showed a striking segmental and interindividual variability. In the thoracic area, two types of traversing veins are observed. Both types show a somewhat symmetrical "inversed V" configuration. No anatomical valves were observed. Nevertheless, anterograde flushing (via the femoral veins) of the vertebral Venous system appeared to proceed much faster than retrograde flushing (via the superior vena cava). The classical picture of the internal vertebral Venous Plexus appears a simplification of the actual situation. Especially in the posterior part, segmental and interindividual differences are prominent. The preferential direction of the flow during flushing suggests the presence of functional valves, which are probably located in the thoracic part of the posterior internal vertebral Venous Plexus, resulting from the typical shape of the veins in this area. This might explain the difficulties with imaging of the posterior part of the internal vertebral Venous Plexus in vitro as well as in vivo. Further study is needed to determine whether the configuration of the posterior internal vertebral Venous Plexus in younger individuals is different, compared with the presently studied aged subjects.
James K Liu - One of the best experts on this subject based on the ideXlab platform.
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dural arterioVenous fistula of the anterior condylar confluence and hypoglossal canal mimicking a jugular foramen tumor case report
Journal of Neurosurgery, 2008Co-Authors: James K Liu, Kelly B Mahaney, Stanley L Barnwell, Sean O Mcmenomey, Johnny B DelashawAbstract:The anterior condylar confluence (ACC) is located on the external orifice of the canal of the hypoglossal nerve and provides multiple connections with the dural Venous sinuses of the posterior fossa, internal jugular vein, and the vertebral Venous Plexus. Dural arterioVenous fistulas (DAVFs) of the ACC and hypoglossal canal (anterior condylar vein) are extremely rare. The authors present a case involving an ACC DAVF and hypoglossal canal that mimicked a hypervascular jugular bulb tumor. This 53-year-old man presented with right hypoglossal nerve palsy. A right pulsatile tinnitus had resolved several months previously. Magnetic resonance imaging demonstrated an enhancing right-sided jugular foramen lesion involving the hypoglossal canal. Cerebral angiography revealed a hypervascular lesion at the jugular bulb, with early Venous drainage into the extracranial vertebral Venous Plexus. This was thought to represent either a glomus jugulare tumor or a DAVF. The patient underwent preoperative transarterial embolization followed by surgical exploration via a far-lateral transcondylar approach. At surgery, a DAVF was identified draining into the ACC and hypoglossal canal. The fistula was surgically obliterated, and this was confirmed on postoperative angiography. The patient's hypoglossal nerve palsy resolved. Dural arterioVenous fistulas of the ACC and hypoglossal canal are rare lesions that can present with isolated hypoglossal nerve palsies. They should be included in the differential diagnosis of hypervascular jugular bulb lesions. The authors review the anatomy of the ACC and discuss the literature on DAVFs involving the hypoglossal canal.
