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Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine
Jan 01, 2024;23 (1): 80-91.

Association between the Putative Meningeal Lymphatics at the Posterior Wall of the Sigmoid Sinus and Delayed Contrast-agent Elimination from the Cerebrospinal Fluid.

Shinji Naganawa, Rintaro Ito, Mariko Kawamura, Toshiaki Taoka, Tadao Yoshida, Michihiko Sone
Author Information
  1. Shinji Naganawa: Department of Radiology, Nagoya University Graduate School of Medicine.
  2. Rintaro Ito: Department of Radiology, Nagoya University Graduate School of Medicine.
  3. Mariko Kawamura: Department of Radiology, Nagoya University Graduate School of Medicine.
  4. Toshiaki Taoka: Department of Radiology, Nagoya University Graduate School of Medicine.
  5. Tadao Yoshida: Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine.
  6. Michihiko Sone: Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine.
PMID: 36653154 DOI: 10.2463/mrms.mp.2022-0110

Abstract

PURPOSE: To investigate the characteristics of the putative meningeal lymphatics located at the posterior wall of the sigmoid sinus (PML-PSS) in human subjects imaged before and after intravenous administration (IV) of a gadolinium-based contrast agent (GBCA). The appearance of the PML-PSS and the enhancement of the perivascular space of the basal ganglia (PVS-BG) were analyzed for an association with gender, age, and clearance of the GBCA from the cerebrospinal fluid (CSF).
METHODS: Forty-two patients with suspected endolymphatic hydrops were included. Heavily T2-weighted 3D-fluid attenuated inversion recovery (hT2w-3D-FLAIR) and 3D-real inversion recovery (IR) images were obtained at pre-administration, immediately post-administration, and at 4 and 24 hours after IV-GBCA. The appearance of the PML-PSS and the presence of enhancement in the PVS-BG were analyzed for a relationship with age, gender, contrast enhancement of the CSF at 4 hours after IV-GBCA, and the washout ratio of the GBCA in the CSF from 4 to 24 hours after IV-GBCA.
RESULTS: The PML-PSS and PVS-BG were seen in 23 of 42 and 21 of 42 cases, respectively, at 4 hours after IV-GBCA. In all PML-PSS positive cases, hT2w-3D-FLAIR signal enhancement was highest at 4 hours after IV-GBCA. A multivariate analysis between gender, age, CSF signal elevation at 4 hours, and washout ratio indicated that only the washout ratio was independently associated with the enhancement of the PML-PSS or PVS-BG. The odds ratios (95% CIs; P value) were 4.09 × 10 (2.39 × 10 - 0.07; 0.0078) for the PML-PSS and 1.7 × 10 (1.66 × 10 - 0.174; 0.014) for the PVS-BG.
CONCLUSION: The PML-PSS had the highest signal enhancement at 4 hours after IV-GBCA. When the PML-PSS was seen, there was also often enhancement of the PVS-BG at 4 hours after IV-GBCA. Both observed enhancements were associated with delayed GBCA excretion from the CSF.

Keywords

endolymphatic hydrops gadolinium glymphatic magnetic resonance imaging

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MeSH Term

Humans
Gadolinium
Contrast Media
Basal Ganglia
Endolymphatic Hydrops
Administration, Intravenous
Magnetic Resonance Imaging

Chemicals

Gadolinium
Contrast Media
Journal Article
Article has an altmetric score of 2

Word Cloud

Created with Highcharts 10.0.0PML-PSS4hoursenhancementIV-GBCAPVS-BGCSFGBCA×100genderagewashoutratiosignalcontrastappearanceanalyzedendolymphatichydropsinversionrecoveryhT2w-3D-FLAIR24seen42caseshighestassociated-1PURPOSE:investigatecharacteristicsputativemeningeallymphaticslocatedposteriorwallsigmoidsinushumansubjectsimagedintravenousadministrationIVgadolinium-basedagentperivascularspacebasalgangliaassociationclearancecerebrospinalfluidMETHODS:Forty-twopatientssuspectedincludedHeavilyT2-weighted3D-fluidattenuated3D-realIRimagesobtainedpre-administrationimmediatelypost-administrationpresencerelationshipRESULTS:2321respectivelypositivemultivariateanalysiselevationindicatedindependentlyoddsratios95%CIsPvalue09239070078766174014CONCLUSION:alsooftenobservedenhancementsdelayedexcretionAssociationPutativeMeningealLymphaticsPosteriorWallSigmoidSinusDelayedContrast-agentEliminationCerebrospinalFluidgadoliniumglymphaticmagneticresonanceimaging

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