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. 2022 Nov;164(11):2999-3010.
doi: 10.1007/s00701-022-05349-w. Epub 2022 Aug 25.

Evaluating diploic vein blood flow using time-resolved whole-head computed tomography angiography and determining the positional relationship between typical craniotomy approaches and diploic veins in patients with meningioma

Kei Yamashiro  1   2 , Akira Wakako  3   4 , Tatsuo Omi  3   4 , Kazuhiro Murayama  5 , Daijiro Kojima  3 , Jun Muto  3 , Kazuhide Adachi  3 , Mitsuhiro Hasegawa  3 , Yuichi Hirose  3
Affiliations

Evaluating diploic vein blood flow using time-resolved whole-head computed tomography angiography and determining the positional relationship between typical craniotomy approaches and diploic veins in patients with meningioma

Kei Yamashiro et al. Acta Neurochir (Wien). 2022 Nov.

Abstract

Background: Diploic veins may act as collateral venous pathways in cases of meningioma with venous sinus invasion. Diploic vein blood flow should be preoperatively evaluated to consider preserving the veins. In this study, we evaluated the use of time-resolved whole-head computed tomography angiography (4D-CTA)-which is less patient-intensive than digital subtraction angiography (DSA)-for assessing diploic vein blood flow and the positional relationship between typical craniotomy approaches and diploic veins.

Methods: We retrospectively examined 231 patients who underwent surgery for intracranial meningioma. We performed contrast-enhanced magnetic resonance imaging (MRI) to evaluate diploic vein pathways and compared the visualization rates of diploic vein blood flow assessed using 4D-CTA and DSA. Subsequently, we evaluated the rates of the diploic veins transected during craniotomy by comparing the pre- and postoperative contrast-enhanced MRI.

Results: The diagnostic performance of 4D-CTA was assessed in 45 patients. Of the 320 diploic veins identified in these patients, blood flow in 70 (21.9%) diploic veins was identified by 4D-CTA and DSA, and both results were consistent. To assess the transection rates of the diploic veins, 150 patients were included. A trend towards a high transection rate of the diploic vein in the basal interhemispheric, frontotemporal, orbitozygomatic, combined transpetrosal, and convexity craniotomy approaches was observed.

Conclusions: In patients with meningiomas, both 4D-CTA and DSA are useful in evaluating diploic vein blood flow. In meningiomas with venous sinus invasion, determining the extent of craniotomy after understanding the pathways and blood flow of diploic veins is recommended.

Keywords: Digital subtraction angiography; Diploic vein blood flow; Meningioma; Time-resolved Whole-head computed tomography angiography.

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References

    1. Alarfaj A, Sankar T, Bhargava R, Tyler J, Walji A, Fox R, Sagga A, Ishaque A, Aronyk K (2021) Magnetic resonance imaging analysis of human skull diploic venous anatomy. Surg Neurol Int 12:249. https://doi.org/10.25259/SNI_532_2020 - DOI - PubMed - PMC
    1. Cheyuo C, Rosen CL, Rai A, Cifarelli CP, Qaiser R (2019) Venous manometry as an adjunct for diagnosis and multimodal management of intracranial hypertension due to meningioma compressing sigmoid sinus. Cureus 11:e4953. https://doi.org/10.7759/cureus.4953 - DOI - PubMed - PMC
    1. Dundar TT, Aralasmak A, Kitis S, Yilmaz FT, Abdallah A (2019) Comparison of subtracted computed tomography from computed tomography perfusion and digital subtraction angiography in residue evaluation of treated intracranial aneurysms. World Neurosurg 132:e746–e751. https://doi.org/10.1016/j.wneu.2019.08.028 - DOI - PubMed
    1. Eisova S, Rangel de Lazaro G, Pisova H, Pereira-Pedro S, Bruner E (2016) Parietal bone thickness and vascular diameters in adult modern humans: a survey on cranial remains. Anat Rec (Hoboken) 299:888–896. https://doi.org/10.1002/ar.23348 - DOI
    1. Garcia-Gonzalez U, Cavalcanti DD, Agrawal A, Gonzalez LF, Wallace RC, Spetzler RF, Preul MC (2009) The diploic venous system: surgical anatomy and neurosurgical implications. Neurosurg Focus 27:E2. https://doi.org/10.3171/2009.8.FOCUS09169 - DOI - PubMed

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