MRI of arachnoid granulations within the dural sinuses using a FLAIR pulse sequence.

Abstract

The purpose of the study was to assess the signal intensities of arachnoid granulations within the dural sinuses using the FLAIR sequence for differentiation of space-occupying lesions in and adjacent to the dural sinuses. We retrospectively reviewed MR images of the brain of 1118 consecutive subjects, ranging in age from 0 to 93 years (mean 57.2 years). Nodules within the dural sinuses with signal intensities similar to that of cerebrospinal fluid (CSF) on both T1 and T2 weighted images were defined as arachnoid granulations. The location, signal intensity on T1 weighted spin echo (SE), T2 weighted fast SE and FLAIR images, the impression on the inner table of the skull, and the size of the lesion were assessed. 112 subjects (10.0%), age range 4-89 years old (mean 58.9 years), were found to have 134 arachnoid granulations. The commonest location was the transverse sinus, with 115 granulations (85.8%). The prevalence of the granulations showed a peak in the sixth decade of age. All granulations were isointense relative to CSF on T2 weighted images and almost all lesions were isointense relative to CSF on T1 weighted images. On FLAIR images, 90.3% of the granulations were isointense relative to CSF and the other 9.7% granulations were slightly hyperintense compared with the CSF. 21 (15.7%) subjects showed impressions on the inner table; one case involved the outer table. In conclusion, arachnoid granulations were isointense or slightly hyperintense relative to CSF on FLAIR. FLAIR images are helpful in differentiating arachnoid granulations from other dural sinus lesions or skull lesions which have an intensity similar to that of CSF on T1 weighted and T2 weighted images.

Brain Herniations into the Dural Venous Sinuses or Calvarium: MRI of a Recently Recognized Entity

“…Arachnoid granulations in the transverse and sigmoid sinuses and in the inner table of the skull are considered normal anatomical variants and are commonly encountered 3 . However, brain parenchyma herniations into a DVS are rare, recently described, and controversial in significance.…”

Cranial Venous Outflow Obstruction and Pseudotumor Cerebri Syndrome

“…Compared to CSF, arachnoid granulations are usually isointense to CSF on T1 weighted, T2 weighted and FLAIR MR imaging but may also have signal characteristics suggesting fat content. Their appearance is variable on proton density images [70] and may be altered by the presence or absence of calcification [142]. Oblique views on MR venography may give the impression of elongated lesion that may be mistaken for thrombus [142].…”

“…On reviewing 100 MR scans there were 14 granulations identified in 13 patients; 85% were closely associated with a vein draining into the sinus. Ikushima et al [70] reviewed static MR images of 1118 patients. Arachnoid granulations were present in 8.3% of males and 12.2% of females.…”

Cranial Arachnoid Protrusions and Contiguous Diploic Veins in CSF Drainage

“…[1][2][3][4] Arachnoid granulations located adjacent to or in the cranial dural sinuses have been explored by using a variety of methods, including neuroimaging, [5][6][7][8][9][10][11][12][13][14][15] postmortem dissection, 5,16,17 investigations by using casting material, 18 and ex vivo studies. 1 However, no report has actually shown the process of CSF absorption in vivo.…”