Comparative analysis of persistent and recanalized falcine sinuses on magnetic resonance venography: insights from healthy individuals and parasagittal meningioma patients

Background: Falcine sinuses can remain persistent after birth, but they can also become recanalized in cases where venous sinuses are invaded by meningiomas.

Purpose: To explore the incidence and imaging features of persistent falcine sinuses in healthy individuals and recanalized falcine sinuses in parasagittal meningioma (PSM) patients on magnetic resonance venography (MRV).

Material and methods: Radiologists evaluated imaging data of 168 healthy individuals and 168 PSM patients. The invasion extent of the superior sagittal sinus (SSS) in PSMs was confirmed by a neurosurgeon based on Sindou's criteria. We compared the incidence and imaging features of persistent and recanalized falcine sinuses.

Results: Among 168 health individuals (mean age = 46.2 ± 9.7 years), 5 (3.0%) persistent falcine sinuses were identified. Among 168 PSM patients (mean age = 53.0 ± 15.0 years), 14 (8.3%) recanalized falcine sinuses were found. Significant differences in SSS invasion extent and location were discovered between cases with and without recanalized falcine sinuses (P < 0.001 and P = 0.029). Recanalized falcine sinuses showed significant higher incidence and larger caliber than persistent ones (for incidence: 8.3% vs. 3.0%, P = 0.034; for caliber: 3.9 ± 1.2 vs. 2.5 ± 0.3 mm, P = 0.005). Under the cutoff of 3.1 mm in caliber with the area under the curve (AUC) of 0.929, we could differentiate between persistent and recanalized falcine sinuses.

Conclusion: Recanalized falcine sinuses in PSMs may form when meningiomas severely invade the posterior portion of the SSS, potentially offering a new perspective to assess sinus invasion. Differences between persistent and recanalized falcine sinuses may reflect different venous drainage status under normal and pathological conditions.