Jugular venous reflux may mimic type I dural arterio-venous fistula on arterial spin labeling magnetic resonance images

Toledano-Massiah, S.; Badat, Neesmah; Ghorra, Camille; Sayadi, Ahmad Reza; Blanc, Raphaël; Gerber, Sophie; Zins, Marc; Leclerc, Xavier; Hodel, Jérôme

doi:10.1007/s00234-019-02346-2

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…59 Another cause is jugular venous reflux, in which venous protons are labeled at the skull base and can actually flow retrograde into the brain. 86 Head and neck malformations may be evaluated using ASL, as long as the image volume is located superior to the label volume. For scalp, face, and skull base lesions, the default labeling plane may suffice.…”

Section: Vascular Malformationsmentioning

confidence: 99%

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Arterial Spin Labeling Applications in Pediatric and Adult Neurologic Disorders

Bambach

Smith

Morris

et al. 2020

Magnetic Resonance Imaging

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Arterial spin labeling (ASL) is a powerful noncontrast magnetic resonance imaging (MRI) technique that enables quantitative evaluation of brain perfusion. To optimize the clinical and research utilization of ASL, radiologists and physicists must understand the technical considerations and age-related variations in normal and disease states. We discuss advanced applications of ASL across the lifespan, with example cases from children and adults covering a wide variety of pathologies. Through literature review and illustrated clinical cases, we highlight the subtleties as well as pitfalls of ASL interpretation. First, we review basic physical principles, techniques, and artifacts. This is followed by a discussion of normal perfusion variants based on age and physiology. The three major categories of perfusion abnormalities-hypoperfusion, hyperperfusion, and mixed patterns-are covered with an emphasis on clinical interpretation and relationship to the disease process. Major etiologies of hypoperfusion include large artery, small artery, and venous disease; other vascular conditions; global hypoxic-ischemic injury; and neurodegeneration. Hyperperfusion is characteristic of vascular malformations and tumors. Mixed perfusion patterns can be seen with epilepsy, migraine, trauma, infection/inflammation, and toxicmetabolic encephalopathy. Level of Evidence: 4 Technical Efficacy Stage: 3

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Section: Vascular Malformationsmentioning

confidence: 99%

“…This can result from venous thrombosis with proximal trapping of labeled protons (the previously described “bright sinus”) 59 . Another cause is jugular venous reflux, in which venous protons are labeled at the skull base and can actually flow retrograde into the brain 86 …”

Section: Hyperperfusion Patternsmentioning

confidence: 99%

Arterial Spin Labeling Applications in Pediatric and Adult Neurologic Disorders

Bambach

Smith

Morris

et al. 2020

Magnetic Resonance Imaging

View full text Add to dashboard Cite

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“…Jugular vein reflux is occasionally observed in healthy patients [ 4 , 5 , 14 ], and some reports have described this phenomenon as mainly caused by compression of the left brachiocephalic vein and jugular valve dysfunction [ 5 , 6 ]. Although jugular valve dysfunction has been thought to be related to transient global amnesia [ 15 ], jugular venous reflux is usually detected incidentally in supine position MRI, and most cases are diagnosed incidentally or exhibit pulsatile tinnitus without severe symptoms [ 5 , 14 , 16 ]. In hemodialysis patients, however, the radial shunt can cause high pressure of the retrograde blood flow into the cerebral dural sinus and potentially lead to intracranial hypertension.…”

Section: Discussionmentioning

confidence: 99%

Retrograde Flow Into the Internal Jugular Vein in a Hemodialysis Patient Mimicking Dural Arteriovenous Fistula: A Case Report

Shiozaki,

Morofuji,

Izumo

et al. 2024

Cureus

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Arterial spin labeling (ASL) and three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) are sensitive tools to detect dural arteriovenous fistula (DAVF), but hyperintensity in these images is also caused by jugular venous reflux. We present a case of a patient with renal failure on hemodialysis with retrograde flow into the internal jugular vein (IJV) mimicking DAVF. A 74-year-old man with a radial arteriovenous fistula for hemodialysis experienced transient dizziness. The TOF MRA and ASL revealed high signal intensity, suggesting the presence of a DAVF in the left transverse and sigmoid sinuses and the IJV. Digital subtraction angiography (DSA) revealed no evidence of a DAVF but showed retrograde flow into the IJV via his radial shunt. In hemodialysis patients, a high-flow shunt can cause fast retrograde flow into the dural sinuses and might lead to intracranial hypertension. The ASL images are useful for early detection and careful observation.

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“…It is worth noting that the mechanisms responsible for IJVR-induced WMLs are similar as those for DAVF-mediated WMLs, since both IJVR and DAVF may manifest with venous hypertension, although the former possibly harbors a lesser degree as mediated by the retrograde venous pressure whilst the latter driven by the rapid arterial shunts. Recent literatures also indicated these two diseases entities shared similar features on MR sequences and may result in confused diagnosis [ 152 , 153 ]. For which, we posit that they may be distinct from the WML intensity, since IJVR may harbor a milder venous hypertension for its venous origin, while the venous hypertension of DAVF may be relatively severer as created by the high-flow arterial source.…”

Section: Cerebrovenous Hypertension and Wmlmentioning

confidence: 99%