脑室内海绵状血管瘤的影像学表现

Imaging Features of Intraventricular Cavernous Angiomas

目的探讨脑室内海绵状血管瘤的影像学特征及鉴别诊断,以提高对该疾病的认识。方法回顾性分析11例经病理证实的脑室内海绵状血管瘤的临床及影像学资料。2例行CT平扫及MRI增强扫描,9例行MRI增强扫描。结果位于侧脑室10例,其中近孟氏孔处5例,侧脑室体部1例,侧脑室后角区4例;位于第三脑室1例。病灶多呈结节状或类圆形,边界清晰,仅1例病灶周围见轻度水肿。CT平扫2例均呈稍高密度,1例见点状钙化;MR T_1WI呈等低信号(8例)或高低混杂信号(3例),其内部或边缘可见小片状稍高信号;T_2WI均为高低混杂信号,可伴小囊状液平(3例)或低信号环(3例)。DWI呈低信号(4例)或高低混杂信号(7例)。增强扫描见边缘点状轻度强化(8例)或明显强化(3例)。结论脑室内海绵状血管瘤以侧脑室多见,CT多为稍高密度,MRI以混杂信号多见,当T_2WI示小囊状液平、低信号环及增强扫描边缘结节状强化时,可作为脑室内海绵状血管瘤的诊断依据。

Objective To investigate the radiological features and differential diagnoses of Intraventricular cavernoma （IVC）,in order to improve the knowledge of this disease.Methods Clinical and radiological data of eleven patients with IVC confirmed with pathology were retrospectively analyzed,of which two cases were examined by CT and enhanced MRI,and nine cases were examined by enhanced MRI.Results Ten cases were located in the lateral ventricle,among which five were near the foramen of Monroe,one was in the body of lateral ventricle and four were in the posterior horns.Only one case was located in the third ventricle.The lesions had a nodular or round morphology with well-demarcated margins,only one case had perilesional edema.Two cases showed slightly higher density and one case had punctate calcification on plain CT.The lesions presented as isointensity or slight hypointensity（8 cases）or inhomogeneous intensity on T1WI （3 case）,with slightly higher signal within the lesion or on the edge.On T2WI,most of the lesions showed inhomogeneous intensity,with vesicular fluid level （3 cases） or hypointensity rim （3 cases）.The lesions exhibited hypointensity （4 cases） or inhomogeneous intensity （7 cases） on DWI.In addition,inconspicuous （8 cases） or significant enhancement （3 cases） on the edge were observed with enhanced MRI.Conclusion IVC most commonly occurs in lateral ventricle,showing slightly high density on plain CT and mixed intensity on MRI.Vesicular fluid level,hyposignal rim on T2WI and nodular enhancement on the edge can be regarded as diagnostic features for IVC.