侧脑室脉络丛黄色肉芽肿的磁共振DWI与ADC诊断

Magnetic resonance DWI and ADC diagnosis of xanthogranuloma of the lateral ventricular choroid plexus

目的探讨磁共振DWI结合ADC值对侧脑室脉络丛黄色肉芽肿的诊断价值。方法回顾性分析江油市人民医院30例侧脑室脉络丛黄色肉芽肿,6例脉络丛囊肿,9例脉络丛肿瘤患者的MRI影像表现,观察病变形态、大小、位置,T1WI、T2WI、T2-FLAIR及DWI(b=0,1000 s/mm^(2))信号特征,分别测量脉络丛黄色肉芽肿、脉络丛囊肿、脉络丛肿瘤以及侧脑室脑脊液ADC值。结果30例脉络丛黄色肉芽肿发生于60岁及以上年龄组18例(60%),60岁以下组12例(40%)。病灶大小0.4~2.4 cm,29例位于侧脑室三角区,1例位于侧脑室体部;发生于双侧26例,单侧4例,左、右侧各2例。病灶均呈结节状,T1W表现均匀低信号,T2WI表现均匀高信号,T2-FLAIR表现为等、稍高信号,DWI表现为高信号,ADC图呈等、稍低信号,ADC值(1.85±0.38)×10^(-3)mm^(2)/s,同时测得脉络丛囊肿、脉络丛肿瘤及侧脑室脑脊液ADC值分别为(3.06±0.12)×10^(-3)mm^(2)/s、(1.45±0.24)×10^(-3)mm^(2)/s、(3.18±0.35)×10^(-3)mm^(2)/s,脉络丛黄色肉芽肿与其两两比较差异均有统计学意义(P<0.05)。结论脉络丛黄色肉芽肿好发于老年人,对称分布于双侧脑室后角,常规T1WI、T2WI与脑脊液信号相似,DWI表现为高信号,结合ADC值具有一定的诊断及鉴别诊断价值。

Objective To explore the diagnostic value of DWI combined with ADC value in xanthogranuloma of choroid plexus of lateral ventricle.Methods The MRI findings of 30 cases of choroid plexus xanthogranulomas,6 cases of choroid plexus cysts,and 9 cases of choroid plexus tumors in lateral ventricle in Jiangyou People’s Hospital were retrospectially analyzed.The morphology,size,location,signal characteristics of T1WI,T2WI,T2-FLAIR and DWI(b=0,1000 s/mm^(2))of the lesions were observed.CSF ADC values of choroid plexus xanthogranuloma,choroid plexus cyst,choroid plexus tumor and lateral ventricle were measured respectively.Results The choroid plexus xanthogranuloma occurred in 18 cases(60%)and12cases(40%)ofthe30cases(60%)aged 60 years and above.The lesion size ranged from 0.4 to 2.4 cm.Twenty-nine cases were located in the trigonum of the lateral ventricle,and 1 case was located in the body of the lateral ventricle.Bilateral lesions occurred in 26 cases and unilateral lesions in 4 cases,including 2 cases on the left and 2 cases on the right.All lesions were nodular,with uniform low signal intensity on T1WI,uniform high signal intensity on T2WI,equal or slightly high signal intensity on T2-FLAIR,high signal intensity on DWI,and equal or slightly low signal intensity on ADC(ADC value(1.85±0.38)×10^(-3)mm^(2)/s).At the same time,the ADC values of choroid plexus cyst,choroid plexus tumor and cerebrospinal fluid of lateral ventricle were(3.06±0.12)×10^(-3)mm^(2)/s,(1.45±0.24)×10^(-3)mm^(2)/s and(3.18±0.35)×10^(-3)mm^(2)/s,respectively,which were statistically different from those of choroid plexus xanthogranuloma(P<0.05).Conclusion Choroid plexus xanthogranuloma is more common in the elderly,and is symmetrically distributed in the posterior horn of bilateral ventricles.Conventional T1WI,T2WI and cerebrospinal fluid signal are similar,and DWI shows high signal.Combined with ADC value,it has certain diagnostic and differential diagnostic value.