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AJR Am J Roentgenol. 2016 Apr;206(4):817-22. doi: 10.2214/AJR.15.14872. Epub 2016 Feb 25.

Prominent Inferior Intercavernous Sinus on Sagittal T1-Weighted Images: A Sign of Intracranial Hypotension.

Author information

1
1 Department of Medical Imaging, St. Michael's Hospital, 30 Bond St, Toronto, ON, M5B 1W8, Canada.
2
2 Department of Radiodiagnóstico, Hospital Clinic, Barcelona, Spain.
3
3 Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.

Abstract

OBJECTIVE:

The purpose of this study is to describe the diagnostic accuracy of the dilatation of the inferior intercavernous sinus as a sign of intracranial hypotension and to raise awareness of this anatomic structure, which can be mistaken for a focal pituitary lesion.

MATERIALS AND METHODS:

Sagittal T1-weighted images of 26 patients with intracranial hypotension and 28 control subjects were evaluated to determine the presence of a distended inferior intercavernous sinus. Information about the shape, size, and signal of the inferior intercavernous sinus was also collected. The chi-square test was used to compare both groups. Sensitivity and specificity of the dilatation of the inferior intercavernous sinus as a sign of intracranial hypotension were calculated.

RESULTS:

A visible inferior intercavernous sinus was found in 13 of 26 patients with intracranial hypotension (50%) and in four of 28 control subjects (14.3%). These percentages were significantly different (p = 0.005). There was no significant difference in size of the inferior intercavernous sinus in the intracranial hypotension group (median, 5.86 mm(2); interquartile range, 6.28 mm(2)) compared with the control group (median, 8.25 mm(2); interquartile range, 16.69 mm(2)). Changes in the size of the inferior intercavernous sinus were detected in congruence with the appearance or resolution of intracranial hypotension.

CONCLUSION:

Dilatation of the inferior intercavernous sinus is frequently associated with intracranial hypotension, although it can also be found in the healthy adult as a normal anatomic variant. Recognition of this anatomic structure is important to avoid mistaking it for a focal pituitary lesion.

KEYWORDS:

T1-weighted MRI; intercavernous sinus; intracranial hypotension

PMID:
27003051
DOI:
10.2214/AJR.15.14872
[Indexed for MEDLINE]

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