Bilateral Rounding of the Shoulders Obstructs Vertebral Vein Drainage of the Vertebral Venous Plexus/Batson's Plexus: MRI/MRA/MRV

Abstract

INTRODUCTION. Costoclavicular compression of the brachiocephalic veins decreases vertebral vein drainage of the vertebral venous plexus / Batson's plexus of the vertebral column. This causes painful head and neck, upper extremity and sacral complaints. Bilateral MRI/MRA/MRV displays sites of venous, lymphatic, and arteries with binding nerve roots. METHODS and MATERIALS. Monitored multiplanar images with 2D Time of Flight MRA/MRV without contrast are acquired on a 1.5 Tesla GE Signa LX unit, 44 cm field of view, 512 x 256 matrix and saline water bags to enhance signal to noise ratio and Fast Spin Echo (FSE) to display lymphedema. RESULTS. Two patients were selected: one post trauma from utility wire exploration with anomalous course of the right axillary artery inferior to the vein and the other from repetitive stress injury with an enlarged thymus gland. CONCLUSIONS. MRI/MRA/MRV is the only monitored imaging modality that displays altered fascial plane anatomy of the brachial plexus. Health professionals need to know landmark anatomy to make an accurate diagnosis.