1 - Neuroradiology Department, Hospital de São José, Centro Hospitalar Lisboa Central, Lisboa, Portugal
2 - Unidade de Neurorradiologia, Hospital Central do Funchal, Funchal, Portugal
3 - Neuroimaging Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
4 - Imagiologia Neurológica, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- XVII Congresso da SPNR, 25 e 26 de Novembro de 2022, Lisboa
Introduction: Dural sinus malformation (DSM) is a very rare condition that is defined by the presence of a dilated dural sinus pouch that presents with mural arteriovenous shunts, either torcular or non torcular. Torcular DSM are generally diagnosed during fetal or neonatal/infantile periods.
Methods: Two cases are presented, both with fetal and postnatal MRI. In the first case has two fetal MRI at 23 and 31weeks of gestation and postnatal MRI at birth, 6 days old and 20 months old. In the second case 5 MRI were performed at 22, 26, 31 and 35 weeks of gestation, as well as post nataly at 4 days old.
Results: Both cases had reduction in size of the DSM with different evolution throughout pregnancy. The first fetal MRIs demonstrate a dilation of the torcula, with partial thrombosis in the first case. In utero follow-up MRIs of this case show partial resolution of the thrombosis and reduction of the torcular ectasia. In the second case, only in the second fetal MRI did the partial thrombosis appear, with some complications in the follow-ups, namely choroidal plexus hemorrhage, venous aneurysm/varicose vein and signal changes in periventricular white matter, probably due to venous congestion. In the afterbirth MRI of both cases we can confirm the involution of the dural sinus malformation with a slight enlargement of some venous structures, without clear AV shunts in the TOF 3D sequences (only seen in the second case).
Conclusion: Prenatal MR imaging is a good tool to assess the whole extension of the dural sinus ectasia, as well as complications such as venous aneurysms, cortical or deep vein involvement and brain parenchyma lesions.
Keywords: Fetal MRI; Dural sinus malformation; torcular