Investigation of structural properties of transverse sinuses with three dimensional volume rendering technique

Year 2025, Volume: 42 Issue: 2, 165 - 169, 30.06.2025

Mehmet Akif Erbaş , Recai Engin , Cengiz Çokluk

Abstract

The detailed description of the neuroanatomical structure of the human brain's venous system, along with the examination of its neurophysiological, neurogenetic, neuropathological, and neurogeometric foundations, has not yet been sufficiently accomplished. The aim of this project is to provide accurate, useful, and up-to-date information on the structural characteristics and variations of the transverse sinuses key components of the brain's venous structures—based on neuroradiological studies. For this study, 44 patients (20 men and 24 women) aged between 20 and 79, who had undergone thin-slice magnetic resonance imaging (MRI) for various reasons at our neurosurgery clinic between 2016 and 2020, were randomly selected. The MRI images, obtained in DICOM format, were rendered into 3D using the volume rendering technique in the OsiriX program, enabling clear visualization of the transverse sinuses. Various angular, length, distance, width, and calibration measurements were then performed on these images. The resulting data were analyzed statistically using the SPSS v25 program. In the majority of patients, the right transverse sinus was dominant. No statistically significant correlation was found between dominance and gender or age (p = 0.681 and p = 0.521, respectively). The exit angle of the right transverse sinus from the torcular Herophili was found to be significantly greater than that of the left transverse sinus (p = 0.013). The diameters of both transverse sinuses were measured just before and just after the junction with the vein of Labbé, and the difference between the pre- and post-junction diameters was found to be statistically significant (p < 0.05). Average distances between the transverse sinuses and the corresponding mastoid processes were determined, but no statistically significant difference was found between the dominant and non-dominant sides (p = 0.447 and p = 0.912, respectively). The use of contrast-enhanced T1-weighted MRI combined with volume rendering to visualize the transverse sinuses in 3D by digitally removing the scalp and bone structures represents a significant advancement for the field of neurosurgery. This method highlights the importance of preoperative visualization of these veins in connection with surgical interventions. Measuring the distance of the transverse sinuses from defined anatomical landmarks and comparing these by age, gender, and dominance represents an innovative approach. Overall, this study will serve as a foundation for future research in brain venous anatomy. The numerical data and statistical findings presented here will be valuable for surgical planning and improving surgical success in centers lacking neuronavigation systems.The use of volume rendering technique with contrast-enhanced T1-weighted magnetic resonance imaging may contribute to the three-dimensional evaluation of the transverse sinuses for surgical planning. This method emphasizes the importance of preoperative visualization of venous structures. The findings of this study may provide a basis for future research on the venous anatomy of the brain and improve surgical success.

Keywords

Transverse Sinus , Torcular Herophilia , Labbe Vein , Venous Variations , Magnetic Resonance Imaging , Three Dimensional Volume Rendering Technique.

References

• Bisaria KK. Anatomic variations of venous sinuses in the region of the torcular Herophili. Journal of neurosurgery. 1985;62(1):90-5.
• Alper F, Kantarci M, Dane S, Gumustekin K, Onbas O, Durur I. Importance of anatomical asymmetries of transverse sinuses: an MR venographic study. Cerebrovascular Diseases. 2004;18(3):236-9.
• Uddin MA, Haq TU, Rafique MZ. Cerebral venous system anatomy. Journal of Pakistan Medical Association. 2006;56(11):516.
• Strydom M, Briers N, Bosman M, Steyn S. The anatomical basis of venographic filling defects of the transverse sinus. Clinical Anatomy: The Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. 2010;23(2):153-9.
• Tanislav C, Siekmann R, Sieweke N, Allendörfer J, Pabst W, Kaps M, et al. Cerebral vein thrombosis: clinical manifestation and diagnosis. BMC neurology. 2011;11:1-5.
• Konstantopoulos K, Giakoumettis D. Chapter 1—Basic knowledge on neuroanatomy and neurophysiology of the central nervous system. Neuroimaging in neurogenic communication disorders. 2023:1-30.
• Rhoton Jr AL. The cerebral veins. Neurosurgery. 2002;51(4):S1-159.
• Kılıç T, Akakın A. Anatomy of cerebral veins and sinuses. Handbook on cerebral venous thrombosis. 2008;23:4-15.
• Koperna T, Tschabitscher M, Knosp E. The termination of the vein of “Labbé” and its microsurgical significance. Acta neurochirurgica. 1992;118:172-5.
• Avci E, Dagtekin A, Akture E, Uluc K, Baskaya MK. Microsurgical anatomy of the vein of Labbé. Surgical and radiologic anatomy. 2011;33:569-73.
• Townsend RK, Jost A, Amans MR, Hui F, Bender MT, Satti SR, et al. Major complications of dural venous sinus stenting for idiopathic intracranial hypertension: case series and management considerations. Journal of neurointerventional surgery. 2022;14(1).
• Pallewatte A, Liyanage N, editors. Normal Variations and Artifacts in MR Venography that may cause Pitfalls in the Diagnosis of Cerebral Venous Sinus Thrombosis2015: European Congress of Radiology-2015 ASM.
• Miyawaki E, Statland J. Cerebral blood vessels: veins and venous sinuses. 2003.
• Altafulla JJ, Prickett J, Iwanaga J, Dumont AS, Tubbs RS. Intraluminal anatomy of the transverse sinus: implications for endovascular therapy. Anatomy & Cell Biology. 2020;53(4):393-7.
• Gunes HN, Cokal BG, Guler SK, Yoldas TK, Malkan UY, Demircan CS, et al. Clinical associations, biological risk factors and outcomes of cerebral venous sinus thrombosis. Journal of International Medical Research. 2016;44(6):1454-61.
• Tubbs RS, Salter G, Oakes WJ. Superficial surgical landmarks for the transverse sinus and torcular herophili. Journal of neurosurgery. 2000;93(2):279-81.
• Larson A, Lanzino G, Brinjikji W. Variations of intracranial dural venous sinus diameters from birth to 20 years of age: an MRV-based study. American Journal of Neuroradiology. 2020;41(12):2351-7.