Tsutsumi Satoshi, Ono Hideo, Ishii Hisato, Yasumoto Yukimasa
Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan.
Childs Nerv Syst. 2019 Mar;35(3):487-491. doi: 10.1007/s00381-018-04044-5. Epub 2019 Jan 6.
The falx cerebri, falx cerebelli, and tentorial notch exhibit a peculiar morphology with a two-layered, dural leaf that protrudes into the cranial cavity with a free edge. However, there are few studies exploring this morphology using neuroimaging techniques. The present study aimed to explore these dural structures using magnetic resonance imaging.
A total of 65 outpatients were included in this study. Following initial examinations with conventional sequences, the constructive interference in steady-state (CISS) sequences were performed in thin-sliced, coronal sections.
In 78% of the subjects, the interdural spaces presenting with high signal were identified in the falx cerebri. These spaces were located adjacent to the uppermost part of the falx, formed by two dural leaves and the superior sagittal sinus, and tapered downward where the leaves united to form the falx cerebri. At the tentorial notch, these spaces were found in 52% of the 65, most predominantly in the medial edge followed by the tentorium cerebelli-tentorial notch junctional region. Forty-one percent of patients had a dural opening into the cerebral cistern. The interdural spaces with high signal were not identified in the tentorium cerebelli in any of the subjects.
The falx cerebri and tentorial notch form the interdural spaces that may provide alternative cerebrospinal fluid pathways. The coronal CISS sequence is suitable for delineating such interdural spaces.
大脑镰、小脑镰和小脑幕切迹呈现出一种独特的形态，即有两层硬脑膜叶，其游离缘突入颅腔。然而，很少有研究使用神经成像技术来探究这种形态。本研究旨在利用磁共振成像探索这些硬脑膜结构。
本研究共纳入65名门诊患者。在使用传统序列进行初步检查后，在薄层冠状位切片上进行稳态构成干扰（CISS）序列检查。
在78%的受试者中，大脑镰内可见呈高信号的硬膜间隙。这些间隙位于大脑镰最上部附近，由两层硬脑膜叶和上矢状窦形成，在叶联合形成大脑镰处向下逐渐变细。在小脑幕切迹处，65名受试者中有52%发现了这些间隙，最主要位于内侧边缘，其次是小脑幕 - 小脑幕切迹交界区。41%的患者有硬脑膜通向脑池的开口。在任何受试者的小脑幕中均未发现呈高信号的硬膜间隙。
大脑镰和小脑幕切迹形成了硬膜间隙，可能提供脑脊液的替代通路。冠状位CISS序列适用于描绘此类硬膜间隙。
