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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How can an MRV report be interpreted when diagnosed with a right parafalcine meningioma?

Hello, I have a right parafalcine menigioma which I have known about since 2012. My recent MRV shows it completely effaces flow related signal and enhancement from a segment of the superior sagittal sinus. It measures a little greater than 3.5 cm in length. There is prominent bilateral cortical venous collateralization coursing posteriorly over the mass to converge with patent sinus at the vertex. There is no cortical venous hypertension. Major dural sinuses otherwise are widely patent. I have done a lot of research over the years and understand quite a bit but I would like an interpretation of what this means.
Tue, 20 Aug 2019
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Neurologist 's  Response
Hello,

In the simplest terms, the interpretation of an MRV study as it relates to your meningioma is a way of trying to detect whether or not there is outflow obstruction to blood entering from the opposite (i.e. arterial) side of the mass.


In your case the number of collateral veins (additional anatomical veins not usually present in people WITHOUT meningiomas) that have developed over time is sufficient and their pathways appear to properly drain into the STRAIGHT SINUS so there is no BACKUP or CONGESTION of bloodflow simply on the part of the meningioma.

There is a REROUTING of venous blood in the area, however, of the mass lesion itself (and that's expected) which is what the "effacement of flow" means in the 3.5cm trajectory of the superior sagittal sinus (i.e. no significant blood flow is found in that part of the egress channel).

In other words, your meningioma is trucking along peacefully without really disturbing the OUTFLOW or egress of the blood from its location such that oxygenation, nutrition, and metabolic waste can still be properly exchanged and executed as if it weren't there.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Dariush Saghafi, Neurologist
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