Liang Luxia, Korogi Yukunori, Sugahara Takeshi, Ikushima Ichiro, Shigematsu Yoshinori, Takahashi Mutsumasa, Provenzale James M
Department of Radiology, Kumamoto University School of Medicine, Kumamoto, Japan.
AJNR Am J Neuroradiol. 2002 Nov-Dec;23(10):1739-46.
The potential pitfalls in the diagnosis of dural sinus thrombosis include the presence of arachnoid granulations, intrasinus fibrotic bands (so-called septa), and hypoplasia or aplasia of the dural sinuses. The purpose of this study was to assess the appearance, distribution, and prevalence of arachnoid granulations and septa in the dural sinuses by using a high resolution 3D contrast-enhanced magnetization prepared rapid acquisition gradient-echo (MPRAGE) imaging sequence.
Conventional MR images and contrast-enhanced MPRAGE images of 100 consecutive patients who had no abnormalities of the dural sinuses were retrospectively reviewed. The incidence, site, number, size, signal intensity, and shape of arachnoid granulations and septa within the sinuses and their relationship with adjacent veins were recorded.
With 3D contrast-enhanced MPRAGE imaging, 433 round, oval, or lobulated focal filling defects were found in a total of 90 patients. Curvilinear septa were observed in 92 patients. Sixty-nine patients had round, oval, or lobulated defects in the transverse sinus, 59 had such defects in the superior sagittal sinus, and 47 had such defects in the straight sinus. All except two of the above defects were isointense relative to CSF on all images. These structures were presumed to be arachnoid granulations. Of 431 arachnoid granulations, 233 (53.8%) were located in the superior sagittal sinus, 122 (28.1%) in the transverse sinus, and 76 (17.6%) in the straight sinus. One or more veins were seen to enter arachnoid granulations in 414 (96%) instances.
The contrast-enhanced 3D MPRAGE imaging sequence showed a much higher prevalence and a different distribution of arachnoid granulations and septa within dural sinuses than have been observed in previous radiologic studies. Arachnoid granulations were closely related spatially to veins.
硬脑膜窦血栓形成诊断中的潜在陷阱包括蛛网膜颗粒、窦内纤维化带（所谓的间隔）以及硬脑膜窦发育不全或未发育。本研究的目的是使用高分辨率三维对比增强磁化准备快速采集梯度回波（MPRAGE）成像序列评估硬脑膜窦中蛛网膜颗粒和间隔的表现、分布及发生率。
回顾性分析100例硬脑膜窦无异常的连续患者的常规磁共振图像和对比增强MPRAGE图像。记录窦内蛛网膜颗粒和间隔的发生率、部位、数量、大小、信号强度、形态及其与相邻静脉的关系。
通过三维对比增强MPRAGE成像，在总共90例患者中发现了433个圆形、椭圆形或分叶状的局灶性充盈缺损。在92例患者中观察到曲线形间隔。69例患者的横窦有圆形、椭圆形或分叶状缺损，59例患者的上矢状窦有此类缺损，47例患者的直窦有此类缺损。上述所有缺损中，除两例外，在所有图像上相对于脑脊液均呈等信号。这些结构被推测为蛛网膜颗粒。在431个蛛网膜颗粒中，233个（53.8%）位于上矢状窦，122个（28.1%）位于横窦，76个（17.6%）位于直窦。在414例（96%）中可见一条或多条静脉进入蛛网膜颗粒。
对比增强三维MPRAGE成像序列显示，硬脑膜窦内蛛网膜颗粒和间隔的发生率比以往放射学研究中观察到的要高得多，且分布不同。蛛网膜颗粒在空间上与静脉密切相关。
