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Evaluation of anterior and middle cranial fossa intraosseous arachnoid granulations with 3D T2-SPACE sequence

Acta Neurol Belg. 2022 Oct 2. doi: 10.1007/s13760-022-02097-7. Online ahead of print.

ABSTRACT

OBJECTIVES: Arachnoid granulations (AG) can be located anywhere outside the dural sinuses. Their presence is thought to be associated with idiopathic intracranial hypertension (IIH) and cerebrospinal fluid (CSF) leaks. It was aimed to evaluate the intraosseous AGs located in the middle and anterior cranial fosses in detail with three-dimensional T2-SPACE (Sampling Perfection with Application optimized Contrasts using different flip angle Evolution-Siemens) imaging and to investigate their clinical significance.

MATERIALS AND METHODS: Sixty-five intraosseous AG of 46 patients were included in this retrospective study. The highest diameter, bone indentation degree (in the inner tabula, diploe distance, reaching and exceeding the outer tabula), content (CSF/+parenchyma) of each AG were evaluated by 2 experienced radiologists. In addition, the presence of other MRI findings supporting IIH was examined.

RESULTS: Additional signs of IIH were detected in 25 patients, and they were statistically significantly more common in the middle cranial fossa. Parenchymal herniation (in four patients) was more common in the young population.

CONCLUSIONS: Intraosseous AGs can be evaluated in detail with T2-SPACE imaging. Determining intraosseous AG is very important both as an indicator of IIH and in terms of its content. T2-SPACE imaging is superior to CT and conventional sequences in this regard.

PMID:36183280 | DOI:10.1007/s13760-022-02097-7

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