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Efficacy of Dural Sinus Quantitative Measurements in Idiopathic Intracranial Hypertension

A Practical Diagnostic Feature

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Abstract

Background and Purpose

This study aimed to investigate the potential contribution of quantitative measurements of dural venous sinuses to the diagnosis of idiopathic intracranial hypertension (IIH) and the relationship between IIH and dural venous sinus dimensions on 3D post-gadolinium T1-weighted magnetic resonance (MR) images.

Material and Methods

A total of 129 individuals (57 IIH patients and 72 controls) who complained of headache and underwent both magnetic resonance venography (MRV) and precontrast/postcontrast 3D T1-weighted MR imaging between 2018 and 2021 were included in this retrospective study. Dural venous sinus and jugular vein diameters were measured in all cases using post-gadolinium 3D T1 TFE images. The presence of transverse sinus (TS) hypoplasia and occipital sinus variation, the number and size of arachnoid granulations in the TS, and the presence of brain parenchymal herniation were also evaluated. Cut-off values that maximized accurate diagnosis of IIH were established on the receiver operating characteristic curve. The sensitivity and specificity of the diagnosis of IIH based on quantitative measurements of the dural sinus were calculated.

Results

The ratios of the maximum to minimum TS diameters and the minimum TS diameters to minimum sigmoid sinus (SS) diameters were significantly higher in IIH patients than in the control group (p < 0.001). The diagnostic sensitivity and specificity values of TSmax/TSmin and TSmin sum/SSmin sum parameters for the detection of IIH were 84.2%, 84.7% and 83.3%, 84.2%, respectively.

Conclusion

Practical measurements from multiplanar T1 sequences can be useful for both quantitative assessment and overcoming misinterpretation due to anatomical variation.

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Abbreviations

AG:

Arachnoid granulation

AUC:

Area under the curve

CSF:

Cerebrospinal fluid

FOV:

Field of view

ICC:

Intraclass correlation coefficient

ICP:

Intracranial pressure

IIH:

Idiopathic intracranial hypertension

IJV:

Internal jugular vein

MRI:

Magnetic resonance imaging

MRV:

Magnetic resonance venography

ROC:

Receiver operating characteristic

SS:

Sigmoid sinus

SSS:

Superior sagittal sinus

TS:

Transverse sinus

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Division of Neuroradiology, Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Bora Korkmazer, Serdar Arslan, Osman Kızılkılıç, Naci Koçer & Civan Islak

  2. Department of Radiology, Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey

    Ahmet Kursat Karaman

  3. Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Esra Kochan Kızılkılıç, Rümeysa Unkun & Uğur Uygunoğlu

  4. Cerrahpasa Tıp Fakültesi Yerleşkesi Kocamustafapasa Cd. No: 53 Cerrahpaşa, 34098, Fatih/Istanbul, Turkey

    Bora Korkmazer

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  1. Bora Korkmazer
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Correspondence to Bora Korkmazer.

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Conflict of interest

B. Korkmazer, A.K. Karaman, E.K. Kızılkılıç, R. Unkun, S. Arslan, U. Uygunoğlu, O. Kızılkılıç, N. Koçer and C. Islak declare that they have no competing interests.

Ethical standards

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent for publication: Patients signed informed consent regarding publishing their data.

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Korkmazer, B., Karaman, A.K., Kızılkılıç, E.K. et al. Efficacy of Dural Sinus Quantitative Measurements in Idiopathic Intracranial Hypertension. Clin Neuroradiol 33, 545–554 (2023). https://doi.org/10.1007/s00062-022-01244-0

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  • DOI: https://doi.org/10.1007/s00062-022-01244-0

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