Calvarial diploic venous channels: an anatomic study using high-resolution magnetic resonance imaging

The calvarial diploic venous channels (CDVCs) are well-known intraosseous structures, but their distribution and anatomofunctional implications are not fully understood.

To investigate the architecture of CDVCs using high-resolution magnetic resonance (MR) imaging.

This prospective study enrolled 43 male and 37 female outpatients who underwent a 3.0-T MR imaging equipped by a 32-channel head coil. T1-weighted imaging covering the whole cranial vault was performed after gadolinium injection. In addition, one-piece orbitozygomatic craniotomy was performed in three cadaveric heads to observe the interruption of the CDVCs.

The CDVCs showed irregular contours and peculiar branching patterns with four common major pathways: the pteriofrontparietal (PFP), frontoorbital (FO), occipitoparietal (OP), and occipitocervical (OC) routes. The proximal PFP coursed as a single trunk and divided into several branches at the level of the frontal eminence. The orbital part of the FO continued to the subcutaneous vein via the supraorbital rim. The PFP and the pterional part of the FO fused proximally with the sphenoparietal sinus and descended as the middle meningeal vein. The OP coursed in the superoinferior direction and connected the junction part of the transverse-sigmoid sinus to the parietal superior sagittal sinus. The OC occurred as a single trunk in the median occipital bone, drained extracranially, and joined the suboccipital venous channels.

The CDVCs seem to be a relatively consistent network functioning not only as conduits connecting the intracranial dural sinuses but also as pathways to the extracranial venous systems. High-resolution MR imaging is useful for investigating the CDVCs.