7 Diploic Space Lesions The diploic space is the marrow-containing area in the skull vault between the inner and outer layers of compact/dense bone. In adults, in whom yellow marrow has supplanted the red marrow of childhood (or in whom there is simply a greater proportion of yellow marrow), this space is visualized as increased SI on T1WI. The SI pattern of the diploic space may vary on T1WI, ranging from uniform high SI to patchy areas to only a small nidus of high SI. Regardless of the distribution of elevated SI, these areas should be symmetric; any asymmetry suggests pathology. Evaluation of the diploic space must be specifically included in the normal search pattern; otherwise subtle lesions will be missed. Metastases to the diploic space may be subtle (Fig. 7.1A) on nonenhanced MRI, but are usually readily evident with contrast administration (Fig. 7.1B
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