P37.09: Dural sinus malformation involving the torcular: prenatal diagnosis with ultrasound and magnetic resonance imaging
Bibliographic record
Abstract
Dural sinus malformation (DSM) is a rare disease consisting of two anatomic types: midline (involving the torcular and adjacent posterior sinuses) and lateral (involving the jugular bulb with otherwise normal sinuses). We report three cases of midline DSM, and discuss the prenatal ultrasound and magnetic resonance imaging (MRI) findings. Institutional ethics approval was obtained. Prenatal ultrasound was performed in three cases, MRI in two and autopsy in two. A literature search was performed for diagnostic and prognostic features. In all three cases, ultrasound demonstrated a mass in the posterior midline of the cranium, with no detectable Doppler flow. Case 1—ultrasound at 19 weeks showed a 1 cm solid mass. MRI demonstrated thrombus in an enlarged torcular. Repeat MRI three weeks later showed the diameter increased to 2 cm and prominent superior sagittal and straight sinuses. Case 2—ultrasound at 21 weeks showed a 3 cm cystic mass with echogenic components. MRI showed a mass of mixed signal intensity in the posterior fossa, with components of both high T1 and T2 signal intensity, consistent with a thrombosed midline DSM. Case 3—ultrasound at 22 weeks showed a 4 cm cystic mass continuous with a dilated superior sagittal sinus. Also noted was a 1 cm hyperechoic mass in the Sylvian fissure. In Cases 2 and 3, there was significant displacement and compression of the cerebellum and in Case 2, severe ventriculomegaly. Autopsy in Cases 2 and 3 confirmed midline DSM, with a large organizing thrombus in Case 2. In Case 3, the mass in the Sylvian fissure was due to a thrombosed dural arteriovenous fistula. Literature review showed prenatal diagnosis of fewer than 20 cases with ultrasound and/or MRI; and pathological correlation uncommon. The prognosis of midline DSM is unfavorable, with high mortality and severe neurological deficit. Midline DSM presents with a spectrum of imaging findings. In utero thrombosis appears common. Prenatal diagnosis is possible with ultrasound and MRI.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".