Comparative analysis of persistent and recanalized falcine sinuses on magnetic resonance venography: insights from healthy individuals and parasagittal meningioma patients.

BackgroundFalcine sinuses can remain persistent after birth, but they can also become recanalized in cases where venous sinuses are invaded by meningiomas.PurposeTo explore the incidence and imaging features of persistent falcine sinuses in healthy individuals and recanalized falcine sinuses in parasagittal meningioma (PSM) patients on magnetic resonance venography (MRV).Material and MethodsRadiologists evaluated imaging data of 168 healthy individuals and 168 PSM patients. The invasion extent of the superior sagittal sinus (SSS) in PSMs was confirmed by a neurosurgeon based on Sindou's criteria. We compared the incidence and imaging features of persistent and recanalized falcine sinuses.ResultsAmong 168 health individuals (mean age = 46.2 ± 9.7 years), 5 (3.0%) persistent falcine sinuses were identified. Among 168 PSM patients (mean age = 53.0 ± 15.0 years), 14 (8.3%) recanalized falcine sinuses were found. Significant differences in SSS invasion extent and location were discovered between cases with and without recanalized falcine sinuses ( < 0.001 and  = 0.029). Recanalized falcine sinuses showed significant higher incidence and larger caliber than persistent ones (for incidence: 8.3% vs. 3.0%,  = 0.034; for caliber: 3.9 ± 1.2 vs. 2.5 ± 0.3 mm,  = 0.005). Under the cutoff of 3.1 mm in caliber with the area under the curve (AUC) of 0.929, we could differentiate between persistent and recanalized falcine sinuses.ConclusionRecanalized falcine sinuses in PSMs may form when meningiomas severely invade the posterior portion of the SSS, potentially offering a new perspective to assess sinus invasion. Differences between persistent and recanalized falcine sinuses may reflect different venous drainage status under normal and pathological conditions.