CSF cleft sign
Citation, DOI & article data
Gaillard F, Baba Y, Lorente E, et al. CSF cleft sign. Reference article, Radiopaedia.org (Accessed on 06 Dec 2022) https://doi.org/10.53347/rID-1134
The CSF cleft sign in neuroimaging can be used to distinguish an extra-axial lesion from an intra-axial lesion and is typically used in the description of a meningioma.
Classically, the cleft was regarded as representing a thin rim of CSF between a tumor and brain parenchyma. However, it often is of high signal on FLAIR imaging (i.e. does not suppress on FLAIR) and most likely represents a non-CSF tumor-brain interface or CSF admixed with solutes.
Nevertheless, it remains a good sign that a mass is extra-axial and typically consists of:
- high T2 signal (representing CSF +/- solutes)
- vessels: pial or larger vessels
- hypointense dura (on both T1 and T2 on the surface of the mass (if extradural)
- 1. Takeguchi T, Miki H, Shimizu T et-al. Evaluation of the tumor-brain interface of intracranial meningiomas on MR imaging including FLAIR images. Magn Reson Med Sci. 2003;2 (4): 165-9. Magn Reson Med Sci (link) - Pubmed citation
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