脑室内海绵状血管瘤MRI诊断(附3例报告并文献复习)

MRI Diagnosis of Ventricular Cavernous Angioma( Report of 3 Cases and Review of the Literatures)

目的探讨脑室内海绵状血管瘤的MRI特点,以提高其术前诊断准确率。方法分析3例脑室内海绵状血管瘤的MRI表现,同时复习国内外相关文献,总结其MRI特点。结果 3例海绵状血管瘤中,1例位于第四脑室,2例位于右侧侧脑室三角区。1例第四脑室海绵状血管瘤呈混杂T_1、混杂T_2信号(肿块周边见短T2信号环),扩散加权成像(DWI)呈不均匀高信号,增强后无明显强化。1例右侧侧脑室海绵状血管瘤呈均匀长T_1、长T_2信号,增强后均匀、明显强化;另1例右侧侧脑室海绵状血管瘤呈等T_1、稍长T_2信号(肿块内见斑条状短T_2信号),DWI呈不均匀高信号,磁敏感加权成像(SWI)呈明显低信号,增强后呈斑片状不均匀强化。3例海绵状血管瘤FLAIR呈明显高信号或高信号为主。结论脑室内海绵状血管瘤MRI表现呈多样性,典型病例类似于脑实质海绵状血管瘤,不典型病例主要与脑膜瘤鉴别。

Objective To evaluate the MRI features of ventricular cavernous angioma. Methods MRI findings of 3 ventricular cavernous angiomas were analyzed retrospectively with reference to literature review. Results In 3 ventricular cavernous angiomas,1 mass located in the fourth ventricle and 2 masses in the right lateral ventricle. The cavernous angioma of the fourth ventricle showed a mixed intensity mass on T1 WI and T2 WI. Low signal rim around the mass could be seen on T2 WI. The mass showed inhomogeneous high intensity on DWI sequence and little enhancement on enhancement scan.A cavernous angioma in the right lateral ventricle showed homogeneous low intensity on T1 WI and high intensity on T2 WI,homogeneous obvious enhancement on enhancement scan. The other mass in the right lateral ventricle showed isointensity on T1 WI and slight high intensity on T2 WI. The mass demonstrated high intensity on DWI and low intensity on SWI,patchy enhancement on enhancement scan. 3 ventricular cavernous angiomas appeared all or most of high intensity on FLAIR.Conclusion The MRI features of ventricular cavernous angiomas are variable. Typical mass is similar with parenchymal cavernous angioma. The atypical mass must be distinguished from the meningioma.