• Yan Tianfang, Xu Liang, Wei Yukui, Lin Qingtang, Jiao Liqun, and Xu Geng.
• Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
• World Neurosurg. 2018 Nov 1; 119: e623-e630.

ObjectivesTo prospectively evaluate the diagnostic value of 3.0 Tesla magnetic resonance 3-dimensional sampling perfection with application-optimized contrast using different flip angle evolution (3D-SPACE) in the detection of sinus wall invasion and sinus patency in parasinus meningiomas.MethodsIn this study, 28 patients with suspected meningiomas adjacent to the venous sinus underwent conventional magnetic resonance imaging, contrast-enhanced magnetic resonance venography, and 3D-SPACE scans. We collected patient charts and surgical reports for demographic details, histologic analysis, and neurologic performance preoperatively and postoperatively. Images obtained by each technique were assessed independently by 2 neurosurgeons for characteristics of sinus infiltration, wall invasion, lumen patency, and collateral veins.ResultsThe blood flow signal inside the lumen and collateral veins were depressed and presented as black, contrasting well with the sinus wall on 3D-SPACE imaging. When the curved-planar reconstruction images were combined, it was intuitive and accurate to detect the extent of sinus wall invasion by meningioma and also to detect lumen patency. An intratumoral "false lumen" was shown to maintain the blood flow inside the sinus at a totally invaded lesion. Moreover, collateral veins enveloped in a meningioma with their confluence points of the venous sinus were easily observed on 3D-SPACE images.ConclusionWith an integrative presentation of parasinus meningioma, wall invasion, lumen patency, and collateral veins, high-resolution 3D-SPACE imaging provides a reliable technique to accurately assess venous sinus invasion preoperatively.Copyright © 2018. Published by Elsevier Inc.

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