Evaluation of Arachnoid Granulations in Cranial Dural Sinuses with Contrast-Enhanced 3-Dimensional T1-Weighted Magnetic Resonance Imaging.

OBJECTIVE: Several studies in the literature have used contrast-enhanced magnetic resonance imaging to investigate arachnoid granulations protruding into the cranial dural sinuses. The current study aimed to investigate the protrusion of arachnoid granulations into the superior sagittal sinus, transverse sinus, straight sinus, and confluence of sinuses and determine the frequency of brain herniation into giant arachnoid granulations using contrast-enhanced 3-dimensional T1-weighted magnetic resonance imaging.

MATERIALS AND METHODS: Images of 550 patients with intra-sinus arachnoid granulations who underwent contrast-enhanced 3-dimensional T1-weighted thin-slice magnetic resonance imaging were retrospectively re-evaluated. Only 300 patients with at least 1 intra-sinus arachnoid granulation were included in the study. The protrusion of arachnoid granulations into superior sagittal sinus, transverse sinus, straight sinus, and confluence of sinuses was investigated. In addition, large arachnoid granulations and brain herniations into arachnoid granulations were also noted.

RESULTS: A total of 889 focal filling defects of arachnoid granulations, at least 1 in the dural sinus, were detected. Of the filling defects of arachnoid granulations, 183 were in the right transverse sinus, 222 in the left transverse sinus, 265 in superior sagittal sinus, 185 in straight sinus, and 34 in confluence of sinuses. Brain herniation into arachnoid granulations was detected in 8 (2.7%) of the patients included in the study. All the filling defects detected in the dural sinuses on post-contrast 3-dimensional T1-weighted images were isointense with cerebrospinal fluid and had round, oval, or lobulated contours. A positive weak correla- tion was found between patient age and the size and number of arachnoid granulations (r = 0.181, P < .01 and r=0.207, P < .001, respectively). It was observed that the size and number of arachnoid granulations increased as the age of the patients increased.

CONCLUSIONS: The distribution, shape, number, and size of intra-sinus arachnoid granulations can vary considerably. Brain herniation into arachnoid granulation can also be seen. Three-dimensional cranial magnetic resonance imaging sequences can be safely used in the evaluation of arachnoid granulations.