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Calvarial diploic venous channels: delineation with maximal intensity projection technique

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Abstract

Purpose

To date, very few studies have explored the three-dimensional architecture of calvarial diploic venous channels (CDVCs). This study aimed to characterize the three-dimensional architecture of CDVCs using maximum intensity projection (MIP) images based on contrast-enhanced magnetic resonance imaging (MRI).

Methods

A total of 77 patients with intact calvarial hemispheres and underlying dura mater and dural sinuses underwent contrast-enhanced MRI. Among them, we extracted the data of 49 with at least a part of the major CDVC pathways identified on the MIP images for analysis.

Results

On serial contrast-enhanced MRI images, the CDVCs were commonly detected as curvilinear structures with inhomogeneous diameters and tributaries, while the MIP images delineated the three-dimensional architecture of the developed CDVC pathways. More than such CDVC pathway was entirely delineated on the right in 67.3% and on the left in 71.4%, most frequently in the frontal and temporal regions, with their connecting sites to the sphenoparietal and superior sagittal sinuses. The morphology, distribution, and course of the identified CDVCs were highly variable. In 55.1%, the CDVCs formed fenestrations that were variable in size, shape, and number.

Conclusions

The developed CDVC pathways may be characterized by morphological variability and fenestrations. Thin-sliced, contrast-enhanced MRI is useful to depict diploic veins, while MIP images allow for better appreciation of the entire course of the developed CDVC pathways. Traumatic and intraoperative disconnection between the dura mater overlying the dural sinuses and the adjacent inner table of the skull can cause epidural venous bleeding.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan

    Satoshi Tsutsumi & Hisato Ishii

  2. Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan

    Hideo Ono

Authors
  1. Satoshi Tsutsumi
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  2. Hideo Ono
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  3. Hisato Ishii
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Contributions

ST conceived the study and wrote the manuscript.HO collected the imaging data. ST and HI analyzed the imaging data.

Corresponding author

Correspondence to Satoshi Tsutsumi.

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Conflict of interest

The authors have no conflicts of interest to declare regarding the materials or methods used in this study or the findings presented in this paper.

Ethical approval

All procedures in this study were performed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all participants included in the study.

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Tsutsumi, S., Ono, H. & Ishii, H. Calvarial diploic venous channels: delineation with maximal intensity projection technique. Surg Radiol Anat 43, 1319–1325 (2021). https://doi.org/10.1007/s00276-021-02729-2

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  • DOI: https://doi.org/10.1007/s00276-021-02729-2

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