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. 2022 Dec 5;220(2):e20220618. doi: 10.1084/jem.20220618

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© 2022 Shah et al.

This article is available under a Creative Commons License (Attribution 4.0 International, as described at https://creativecommons.org/licenses/by/4.0/).

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Figure 5. — Sinus and nonsinus AG types are confirmed by in vivo MRI. MRI examination in young, middle-aged, and old persons confirm the presence of sinus and nonsinus granulations. (A) Type I AG have domes (yellow arrows) located at midline abutting the DVS. (B) Type II AG have domes (yellow arrows) located within dural stroma, which is visualized on FLAIR images as hyperintense perisinus soft tissue (green arrows). (C) Type III AG have domes (yellow arrows) located within skull diploe and are associated with cortical defects of the inner calvarium. (D) Type IV AG have domes (yellow arrows) that are neither intrasinus nor intrastromal in location and abut dura without eroding the calvarial cortex; Type V AG are not definitively observed in this series. (E) Multilobulated hybrid AG types were also occasionally observed, as shown in this example of a Type II/III AG that displayed both stromal and diploic dome embedment. (F) Axial FLAIR image at the calvarial vertex shows superior sagittal sinus (SSS) in the midline with surrounding FLAIR hyperintensity due to a combination of proteinaceous DAS and Type I and Type II AG. Note irregularity of the SSS at the site of Type I AG. (G and H) The distribution of AG types is summarized along the frontal convexities (G) and (H) at distinct frontal levels and highlight a greater percentage of stromal type AG at posterior regions. Data represent 220 frontal granulations from 15 subjects.