Jugular bulb ASL-MRI hyperintensity and severe internal jugular vein stenosis: a potential pitfall in neuroimaging.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-08-01 Epub Date: 2025-04-24 DOI:10.1007/s00234-025-03623-z

Thomas R Geisbush, Siddhant S Dhawan, Periakaruppan V Manickam, Tarik F Massoud

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引用次数: 0

Abstract

Incidental artifactual MRI arterial spin-labeling (ASL-MRI) hyperintense signal at the left jugular bulb (JB-ASL[+]) often creates a neurodiagnostic dilemma because of potential misinterpretation as a dural arteriovenous fistula. JB-ASL(+) likely follows 'benign jugular venous reflux' but an additional contribution to signal genesis owing to styloidogenic jugular venous compression (SJVC) has not been evaluated previously. We studied the link between SJVC percentage stenosis of internal jugular veins (IJVs) and JB-ASL(+) signal intensity by retrospectively reviewing MRIs of 30 JB-ASL(+) patients and 30 age and sex-matched JB-ASL(-) controls. In JB-ASL(+) patients, we found a significantly higher percent increase in ASL-MRI hyperintensity with severe (> 75% IJV stenosis) versus non-severe SJVC (p = 0.026). Thus, in some patients, accentuation of JB-ASL(+) signal conceivably occurs after retrograde trapping of labeled venous blood proximal to a severe SJVC. Presence of severe SJVC represents a novel contributory factor in understanding JB-ASL(+) as a clinically problematic source of neuroimaging misdiagnosis.

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颈静脉球ASL-MRI高强度和严重的颈内静脉狭窄：神经影像学的一个潜在陷阱。

在左颈静脉球（JB-ASL[+]）偶发的人造MRI动脉自旋标记（ASL-MRI）高信号经常造成神经诊断困境，因为可能被误解为硬脑膜动静脉瘘。JB-ASL（+）可能是由“良性颈静脉反流”引起的，但茎突源性颈静脉压迫（SJVC）对信号发生的额外贡献此前尚未得到评估。我们通过回顾性回顾30例JB-ASL（+）患者和30例年龄和性别匹配的JB-ASL（-）对照组的mri，研究了颈内静脉SJVC百分比狭窄（IJVs）与JB-ASL（+）信号强度之间的关系。在JB-ASL（+）患者中，我们发现与非严重SJVC相比，ASL-MRI高强度增加的百分比明显更高（> 75% IJV狭窄）（p = 0.026）。因此，在一些患者中，JB-ASL（+）信号的强化可能发生在严重SJVC近端标记静脉血逆行捕获后。严重SJVC的存在是将JB-ASL（+）理解为神经影像学误诊的临床问题来源的一个新的促成因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.