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. 2018 Sep;4(3):99–104. doi: 10.18383/j.tom.2018.00013

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© 2018 The Authors. Published by Grapho Publications, LLC

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Figure 1. — Utilization of magnetic resonance imaging (MRI) to determine the direction of flow in meningeal lymphatic vessels (MLVs) of a 56-year-old woman. High-resolution coronal SPACE FLAIR image shows MLVs (arrows) adjacent to the superior sagittal sinus (SSS) (arrowhead) (A). Coronal time-of-flight (TOF) sequence with saturation bands, both anterior and posterior to the image section, shows the expected low signal in the SSS (arrowhead) and no signal in the region of the MLVs (arrows) (B). Coronal TOF sequence with a saturation band posterior to the image section shows bright signal in the SSS (arrowhead) (C). The MLVs are not visualized (arrows). Coronal TOF sequence with a saturation band anterior to the image section shows the expected low signal in the SSS (arrowhead) (D). MLVs show increased signal consistent (arrows) with the rostral flow of lymphatic fluid posterior to anterior, countercurrent to the venous flow in the SSS. Difference image generated by subtracting coronal TOF sequence with a saturation band posterior (C) from coronal TOF sequence with saturation bands both anterior and posterior (B) shows the expected flow-related enhancement in the SSS only (arrowhead) and not in the MLVs (arrow) (E). Difference image generated by subtracting coronal TOF sequence with a saturation band anterior (D) from coronal TOF sequence with saturation bands both anterior and posterior (B) shows more clearly the flow-related enhancement in the MLV (arrow) and lack of enhancement in the SSS (arrowhead) (F).