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The circumventricular organs of the brain: conspicuity on clinical 3T MRI and a review of functional anatomy

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Abstract

Purpose

The circumventricular organs (CVOs) occupy seven midline locations around the ventricles. They contain specialized ependymal cells called tanycytes and have an incomplete blood–brain barrier (BBB). We hypothesized that appearances of the lesser known CVOs on contrast-enhanced MRI might lead to confusion in image interpretation whereby they might be mistaken for pathology-related abnormal contrast enhancement. We therefore assessed the normal appearances and prevalence of contrast enhancement of the CVOs on routine clinical brain MRI and reviewed the functional anatomy of the CVOs.

Methods

We retrospectively reviewed sagittal and coronal pre- and post-contrast T1-weighted brain 3T MR images in 100 adult patients with normal findings. We assessed the presence of the median eminence (ME), neurohypophysis (NH), pineal gland (PG), subforniceal organ (SFO), organum vasculosum of the lamina terminalis (OVLT), subcommissural organ (SCO), and the area postrema (AP).

Results

The frequency of contrast enhancement of the seven CVOs was as follows: ME in 100 %, NH in 96 %, PG in 84 %, SFO in 1 %, OVLT in 34 %, SCO in 0 %, and AP in 2 %.

Conclusions

The main CVOs (ME, NH, and PG) are well known and appreciated on brain imaging. However, there is a little awareness of the minor CVOs among neuroimagers. This is the first study of contrast enhancement prevalence of the SF, OV, SC, and AP on brain MRI. All the latter are small, faint, rarely visualized, and therefore not likely to cause misinterpretation with significant sources of pathology that cause breakdown of the BBB, such as tumor or inflammation.

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Conflict of interest

We declare that we have no conflict of interest.

Ethical standards

This study complies with the current laws of the country in which it was performed.

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Authors and Affiliations

  1. Department of Radiology, Addenbrooke’s Hospital, 218 Hills Road, CB2 2QQ, Cambridge, UK

    Avril Horsburgh & Tarik F. Massoud

  2. The University of Cambridge, Cambridge, UK

    Tarik F. Massoud

Authors
  1. Avril Horsburgh
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  2. Tarik F. Massoud
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Correspondence to Tarik F. Massoud.

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Horsburgh, A., Massoud, T.F. The circumventricular organs of the brain: conspicuity on clinical 3T MRI and a review of functional anatomy. Surg Radiol Anat 35, 343–349 (2013). https://doi.org/10.1007/s00276-012-1048-2

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  • DOI: https://doi.org/10.1007/s00276-012-1048-2

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