Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Surg Radiol Anat. 2024 Jul;46(7):993-999. doi: 10.1007/s00276-024-03382-1. Epub 2024 May 11.
The chordae Willisii (CWs), trabecular projections into the lumen of the dural sinuses, are not well understood. We aimed to explore them using magnetic resonance imaging (MRI).
Eighty-five patients underwent volumetric contrast-enhanced MRI, while another 30 underwent a fluid-attenuated inversion recovery (FLAIR) sequence in the coronal section.
The CWs were detected as linear filling defects lying in the dural sinuses, adjacent to the surrounding dura mater. They were found in the superior sagittal sinus (SSS) in 68.2% of the patients, most frequently in the middle third, with laminar appearance. In 27.1% of the patients, the CWs divided the SSS lumen into separate channels. The CWs were identified in the transverse sinus, transverse-sigmoid sinus junctional area and sigmoid sinus, and straight sinus in 54.1, 47.1, and 8.2%, respectively. On the FLAIR images, dural septi partially dividing the SSS lumen were identified in all patients. In addition, in 73.3% of the patients, fine linear structures were observed in the lumen with inconstant arrangements.
The CWs may be constant structures distributed over the lumen of the intracranial dural sinuses. Contrast-enhanced MRI may be useful for detecting laminar CWs. The FLAIR sequence may be advantageous for delineating the dural septi projecting into the lumen of the dural sinuses.
Willis 氏腱索（CWs）是突入硬脑膜窦腔的小梁状突起，其功能尚未完全明确。我们旨在通过磁共振成像（MRI）对其进行研究。
85 例患者接受容积对比增强 MRI 检查，另外 30 例患者接受冠状位液体衰减反转恢复（FLAIR）序列检查。
CWs 表现为线性充盈缺损，位于硬脑膜窦内，邻近周围硬脑膜。68.2%的患者在大脑上矢状窦（SSS）中发现 CWs，最常见于中 1/3 段，呈层状外观。27.1%的患者 CWs 将 SSS 腔分为单独的通道。CWs 在横窦、横窦-乙状窦结合区和乙状窦中分别被识别出 54.1%、47.1%和 8.2%。在 FLAIR 图像上，所有患者均可见部分分隔 SSS 腔的硬脑膜隔。此外，73.3%的患者在窦腔中观察到不定排列的细线性结构。
CWs 可能是分布于颅内硬脑膜窦腔的恒定结构。增强 MRI 可能有助于检测 CWs 的层状结构。FLAIR 序列可能有利于描绘突入硬脑膜窦腔的硬脑膜隔。
