CT and MRI Findings of Intracranial Cavernous Hemangioma Malformation

Objective:To investigate the computed tomography(CT)and magnetic resonance imaging(MRI)features of cavernous hemangioma malformation(CHM)to enhance diagnostic accuracy.Methods:The CT and MRI findings and clinical information of 23 patients with CHM were retrospectively analyzed.Results:CT examinations were conducted in 7 cases,while MRI was utilized in 23 cases.Additionally,SWI was employed in 5 cases and enhanced imaging techniques were applied in 14 cases.Among the observed lesions,20 cases presented with a singular lesion,whereas 3 cases exhibited multiple lesions.The lesions were located in 8 frontal lobes,6 cerebellums,2 brainstems,6 temporal lobes,1 basal ganglia,3 parieto-occipital lobes,and 2 thalamus regions.The nodules appeared as quasi-circular lesions with clear or well-defined boundaries.They presented as isodense lesions on CT scans,with one lesion showing peritumoral edema.On MRI,T1-weighted imaging(T1WI)demonstrated isointense signals,while T2-weighted imaging(T2WI)showed isointense and hyperintense signals.Additionally,10 lesions exhibited a low signal ring on T2WI.Diffusion-weighted imaging(DWI)revealed nodular or isointense low signals,while susceptibility-weighted imaging(SWI)displayed enlarged areas of low signal.Fourteen lesions underwent contrast-enhanced scanning,with 2 lesions showing no obvious enhancement,1 lesion demonstrating mild to moderate enhancement,and 11 lesions exhibiting significant enhancement.Notably,6 of these enhanced lesions were surrounded by small blood vessels.Conclusion:Cavernous hemangioma malformation is more commonly found in individual cases.CT alone lacks specificity,making it prone to misdiagnosis.A more comprehensive evaluation of cavernous hemangioma malformation can be achieved through a combination of MRI,DWI,SWI,and enhanced examination,providing valuable references for clinical assessment.

Necessity of Magnetic Resonance Imaging (MRI) using an appropriate sequence for diagnosis of trigeminal neuralgia associated with intracranial tumor

Aims: Trigeminal neuralgia is generally caused by neurovascular compression. In rare cases intracranial tumors may also lead to this condition. The present study was conducted to identify clinical symptoms and testing methods that are useful for early detection of trigeminal neuralgia associated with intracranial tumor. Methods: Five patients with trigeminal neuralgia suspected to be due to intracranial tumor, who visited our department for the first time during the period between February 2007 and March 2009, were examined. We analyzed the medical records and MRI findings of these patients. The clinical symptoms of subjects were compared to those presented at the International Classification of Headache Disorders. Results: There were no feature symptoms to trigeminal neuralgia caused by intracranial tumors compared with trigeminal neuralgia in general. None of the patients complained of spontaneous headache and nausea, which are clinical symptoms characteristic of brain tumor. Head MRI at our hospital was the most accurate method to detect intracranial tumors. Finally four of five patients received brain surgery to remove tumors. Conclusion: Small tumors and roots of the trigeminal nerve may not create accurate images by regular head MRI. Therefore, MRI using the imaging sequence which enables accurate visualization of roots of the trigeminal nerve is essential to confirm the presence of tumors in patients with suspected trigeminal neuralgia.

Endovascular transvenous treatment for superficial intracranial arteriovenous malformations

Objective:The objective of this study was to evaluate the feasibility and outcomes of transvenous endovascular embolization(TVE) for superficial intracranial arteriovenous malformations(AVMs).Methods:After collecting clinical and imaging data,a prospective series of 11 patients presenting with superficial AVMs were treated by endovascular embolization using a transvenous approach between November 2016 and October 2018.Results:Ten patients(90.9%) had ruptured AVMs before TVE.The mean nidus size was 3.27 ± 1.47 cm,and the median Spetzler-Martin grade was II.The rate of immediate angiographic occlusion of the AVMs was 90.9%(10/11).One patient was treated with transarterial embolization since TVE was not achieved due to an unsuccessful positioning of the microcatheter.Two patients(cases 8 and 11) suffered a intracranial hemorrhage and a cerebral infarction with encephaledema,respectively,but no procedure-related mortalities were observed.Eight patients(72.7%) were independent with a modified Rankin Score(mRS) 2 at discharge and the m RSs of all patients,which were collected 30 days postintervention,were not more than 2.The mean follow-up period was 17 months.There were no nidus recurrences during the follow-up period.Conclusions:The curative transvenous embolization of superficial AVMs seems feasible and effective while carefully monitoring for embolization-related complications.

Color Fusion of Magnetic Resonance Images Improves Intracranial Volume Measurement in Studies of Aging

Background: Comparison of intracranial volume (ICV) measurements in different subpopulations offers insight into age-related atrophic change and pathological loss of neuronal tissue. For such comparisons to be meaningful the accuracy of ICV measurement is paramount. Color magnetic resonance images (MRI) have been utilised in several research applications and are reported to show promise in the clinical arena. Methods: We selected a sample of 150 older community-dwelling individuals (age 71 to 72 years) representing a wide range of ICV, white matter lesions and atrophy. We compared the extraction of ICV by thresholding on T2*-weighted MR images followed by manual editing (reference standard) done by an analyst trained in brain anatomy, with thresholding plus computational morphological operations followed by manual editing on a framework of a color fusion technique (MCMxxxVI) and two automatic brain segmentation methods widely used, these last three done by two image analysts. Results: The range of ICV was 1074 to 1921 cm3 for the reference standard. The mean difference between the reference standard and the ICV measured using the technique that involved the color fusion was 2.7%, while it was 5.4% compared with any fully automatic technique. However, the 95% confidence interval of the difference between the reference standard and each method was similar: it was 7% for the segmentation aided by the color fusion and was 7% and 8.3% for the two fully automatic methods tested. Conclusion: For studies of aging, the use of color fusion MRI in ICV segmentation in a semi-automatic framework delivered best results compared with a reference standard manual method. Fully automated methods, while fast, all require manual editing to avoid significant errors and, in this post-processing step color fusion MRI is recommended.

Diagnostic value of contrast-enhanced fluid-attenuated inversion-recovery MRI for intracranial tumors in comparison with post-contrast T1W spin-echo MRI

Background Contrast-enhanced fluid-attenuated inversion-recovery （FLAIR） magnetic resonance imaging （MRI） has been reported to have higher sensitivity for detecting leptomeningeal disease compared with contrastenhanced T1-weighted MRI （CE T1WI）. However, currently there are no studies showing the potential value of clinical applications of contrast-enhanced FLAIR （CE FLAIR） sequence in diagnosing intracranial tumors in a larger group of patients. The purpose of this study was to evaluate the diagnostic value of CE FLAIR in comparison with CE TlWI for intracranial tumors and to provide more information for clinical diagnosis and therapy. Methods One hundred and four consecutive cases of intracranial tumors referred for CE brain MRI were analyzed with regard to FLAIR and TlWI pre- and post-administration of Gd-DTPA. The CE FLAIR and CE TlWI were evaluated independently by two radiologists for the number of examinations with one or more enhanced lesions, the number and location of enhanced lesions per examination, signal-to-noise ratio （SNR） and contrast-enhancement ratio （CER） of lesions, as well as the size and extent of the enhanced lesions. Results In 98 of 104 cases, enhanced lesions were seen both on the FLAIR and TlW images. More lesions were seen on CE TlWI （n=120） than those on CE FLAIR sequence （n=llT）, but no differences of statistical significance were found between the two sequences （/＇〉0.05）. Four lesions were revealed only on the CE FLAIR images whereas 7 lesions were only found on CE TlWI. Enhanced lesions located in the cerebral hemisphere or the forth ventricle were revealed much more on CE T1WI than on CE FLAIR images. However, CE FLAIR images may be useful in showing superficial abnormalities and those located in the sulcus or lateral ventricle. The CER and contrast-to-noise ratio （CNR） on CE T1WI was significantly higher （t=7.10, P=0.00; t=9.67, P=0.00, respectively）, but grey matter/white matter contrast was lower （t=-2.46, P=-0.02） than those on CE FLAIR images. The SNR did not show any statistically significant difference between the two sequences （t=-1.1, P=-0.27）. The size and extent of lesions on the CE FLAIR images were significantly larger than those on CE TIWI （t=4.13, P=0.00）.

Concurrent occurrence of both intracranial and intramedullary tuberculomas

Tuberculosis involving spinal cord in the form of intramedullary tuberculoma is uncommon,and the concurrent occurrence of cranial and intramedullary tuberculomas is extremely rare.We report a case of disseminated tuberculoma involving brain and spinal cord with miliary tuberculosis in a 32‑year‑old male presenting with fever,cerebellar signs and motor weakness of both upper and lower extremities.Based on magnetic resonance imaging and polymerase chain reaction,we diagnosed as tuberculoma.He completely recovered with conventional antituberculous treatment and steroids.The follow‑up of the patient showed disappearance of signs and symptoms.

Giant Tuberculomas Suggesting a Malignant Brain Tumor: About Two Cases

Tuberculoma is a common condition in developing countries. In some cases, it may mimic a glial lesion, making differential diagnosis challenging. The authors report two cases of giant tuberculoma in young patients aged 14 and 16. A literature review was conducted on these cases. Both patients underwent partial excision. Histology concluded tuberculoma. Anti-tubercular treatment was implemented. The evolution one year later was marked by the persistence of neurological disorders, although they had improved.

颅内海绵状血管瘤MRI-SWI T1WI T2FLAIR增强序列检查特征比较观察

目的:探讨磁共振敏感加权成像(MRI-SWI)、磁共振T1加权成像(T1WI)、T2加权成像(T2WI)、T2液体衰减反转恢复序列(T2FLAIR)在诊断颅内海绵状血管瘤中的应用价值。方法:选取延安大学附属医院2019年3月至2023年3月初步诊断怀疑为颅内海绵状血管瘤患者153例作为研究对象,所有患者均在手术前完成了MRI检查,包括MRI-SWI、T1WI、T2WI、T2FLAIR检查,以手术病理学检查结果作为金标准,计算各种MRI检查方式对于诊断颅内海绵状血管瘤的价值。结果:MRI-SWI正确诊断97例海绵状血管瘤患者,共计准确检出病灶数量177个,T1WI正确诊断72例海绵状血管瘤患者,共计准确检出病灶数量121个,T2WI正确诊断77例海绵状血管瘤患者,共计准确检出病灶数量132个,T2FLAIR正确诊断82例海绵状血管瘤患者,共计准确检出病灶数量143个,MRI-SWI对海绵状血管瘤病灶的检出率高于T1WI、T2WI、T2FLAIR(χ^(2)=28.698、P<0.05,χ^(2)=22.299、P<0.05,χ^(2)=16.257、P<0.05);T2FLAIR对海绵状血管瘤病灶的检出率高于T1WI(χ^(2)=7.211、P<0.05);T1WI、T2WI对海绵状血管瘤病灶的检出率差异无统计学意义(χ^(2)=1.676、P>0.05);T2FLAIR、T2WI对海绵状血管瘤病灶的检出率差异无统计学意义(χ^(2)=1.972、P>0.05);T1WI海绵状血管瘤病灶主要表现为混杂信号(43.80%)、其次为低信号(30.58%);T2WI海绵状血管瘤病灶主要表现为混杂信号(49.24%),主要特征为病灶中央呈点状或网格状高信号,周围边缘低信号,称之为“铁环征”,其次为低信号(35.61%);T2FLAIR海绵状血管瘤病灶主要表现为类圆形或者圆形的混杂信号(58.33%),病灶内部显示为爆米花或者网格状,其次为低信号(34.09%);MRI-SWI海绵状血管瘤病灶主要表现为低信号(95.48%),主要显示病灶的周围含铁血黄素区域及瘤体,病灶周边及内部显示片状或点状低信号;T1WI、T2WI、T2FLAIR、MRI-SWI鉴别诊断海绵状血管瘤患者的灵敏度分别为74.23%、79.38%、84.54%、100%,特异度分别为85.71%、83.93%、78.57%、94.64%。结论:颅内海绵状血管瘤患者在接受MRI检查的情况下,MRI-SWI序列较T1WI、T2WI、T2FLAIR序列具有更高的诊断价值。

新生儿颅内出血MRI影像学特征与临床表现对预后的影响研究

目的探讨新生儿颅内出血MRI影像学特征与临床表现对预后的影响。方法选取2020年1月至2022年6月宜春市妇幼保健院收治的80例新生儿颅内出血患儿作为研究对象,所有患儿均行MRI检查,并收集患儿临床资料。分析不同出血类型患儿早产、病因、临床表现、预后情况。结果80例患儿中,蛛网膜下腔出血39例,MRI影像表现为T_(1)加权像(T_(1) weighted image,T_(1)WI)高信号,T_(2)加权像(T_(2) weighted image,T_(2)WI)、磁敏感加权成像(susceptibility weighted imaging,SWI)低信号,T_(2)WI也可为等信号;脑室周围-脑室内出血22例,MRI影像表现为T_(1)WI、T_(2)WI等信号或低信号,SWI低信号;脑实质或硬膜下出血19例,MRI影像表现为T_(1)WI高信号,T_(2)WI、SWI低信号。SWI影像可较T_(1)WI、T_(2)WI影像观察到更明显、清晰的低信号影。蛛网膜下腔出血、脑室周围-脑室内出血、脑实质或硬膜下出血患儿早产、足月发生率比较差异有统计学意义(P<0.05),但两两比较差异无统计学意义。蛛网膜下腔出血、脑室周围-脑室内出血、脑实质或硬膜下出血患儿产伤、感染、出血性疾病、颅内高压、脑膜刺激征、意识障碍发生率及预后情况比较差异无统计学意义。结论MRI影像学用于新生儿颅内出血的检查,可准确评估患儿的颅内出血类型,分析疾病诱发原因,结合临床表现制订相应治疗方案,有利于改善患儿预后,值得临床推广应用。

肝结核瘤的MRI征象

目的 分析肝结核瘤的MRI表现 ,探讨MRI在诊断和鉴别诊断中的价值。资料与方法 10例肝结核瘤患者行MR自旋回波序列T1WI、T2 WI和快速多层面干扰梯度回波序列动态增强扫描。结果 10例共 12个病灶 ,MRI表现 :(1)自旋回波序列 :T1WI上所有病灶为低信号 ,T2 WI上 10个病灶为不均匀低信号 (8个病灶为中心低信号而边缘为环形或片状的高信号 ,2个为低信号中见到点状高信号 ) ,另 2个病灶为高信号。 (2 )增强扫描 :动脉期10个病灶无强化 ,2个病灶边缘有轻度强化。门脉期和延迟期所有病灶均有不同方式的强化 ,主要为边缘强化和分隔强化。结论 MRI可反映肝结核瘤的病理改变过程 。

颅内结核性脑膜炎的MRI诊断

目的 评估MRI对颅内结核性脑膜炎的诊断价值。材料与方法 对 18例颅内结核性脑膜炎的MRI表现、Gd DTPA增强的作用和追踪MRI的变化进行分析。结果 MRI显示脑膜炎 13例 ,表现为蛛网膜腔狭窄和消失 ,脑脊液分房。在增强MRI上 ,受累的脑膜呈线形、弥漫性斑块和结节状或环状显著性强化。结核性脑膜炎合并结核瘤 2例 ,结核性脑脓肿 2例 ,脑梗塞 1例。结论 结核性脑膜炎的MRI表现有一定的特点 ,增强MRI可以清楚地显示出结核性脑膜炎受累的形态学和病理学改变。因此 ,MRI检查对颅内结核性脑膜炎的诊断价值 ,无论是在急性期或慢性期 。

肺结核瘤MRI与CT检查的对比研究分析

目的探讨肺结核瘤MRI与CT检查对比分析。方法收集21例因肺内占位就诊、经病理证实为结核瘤的MRI与CT检查资料,MRI检查包括平扫、DWI及动态增强扫描,CT检查包括平扫与增强扫描;对两种检查方法的影像特点进行分析。结果肺部结核瘤21例病例T1WI全部显示低信号,T2WI显示16例为周边高信号,中央区低信号,5例为高信号。DWI图像显示均为高信号或稍高信号,平均ADC值为(1.60±0.18)s/mm2。动态增强扫描动脉期17病例边缘完全或不完全环状强化,中央区无强化或轻度强化。时间-强度曲线6例表现为缓慢流入型,4例表现为缓慢流出型。CT平扫显示肺结核瘤显示低密度,增强扫描轻度强化,其中10例显示完全或不完全环状强化。时间-密度曲线显示为6例为缓慢上升型,4例为早期快速上升,缓慢下降型。结论MRI与CT对肺结核瘤的诊断都具有重要价值,MRI对于病变的薄环状强化的显示更具有优越性,CT对钙化的检查具有优越性。

颅内动脉瘤的MRI、MRA与DSA对照研究

目的 运用MRI、MRA及DSA对颅内动脉瘤进行对比分析研究 ,并分别探讨它们对治疗的价值。方法 2 0例颅内动脉瘤患者同时行MRI、MRA和DSA检查 ,探讨它们各自对颅内动脉瘤的大小、形态、瘤腔内血栓的显示情况。结果 2 1个动脉瘤中 ,MRI、DSA、MRA显示瘤腔内血栓分别为 8、3、3个 ,DSA、MRA显示瘤颈分别为 18、17个。结论 MRI对动脉瘤腔内血栓的显示具有较高的敏感性 ,DSA、MRA能够清晰显示动脉瘤的大小、形态以及瘤颈与载瘤动脉的关系。

MRI的FLAIR序列在颅内出血中的诊断价值

评价 MRI的液体衰减反转恢复序列 ( FLAIR)在颅内出血中的应用价值。方法 回顾性分析 2 8例颅内出血患者 MRI常规序列及 FLAIR序列图像表现。其中脑内出血 2 3例 ,合并蛛网膜下腔出血 1 2例 ,合并脑室出血 4例 ;硬膜下出血 3例 ;肿瘤出血 2例。全部患者均在发病后 3～ 1 0天内行 MR检查。结果 硬膜下出血 ,MR常规扫描及 FLAIR序列均可清晰显示 ,两者之间无显著差异 ;在鉴别亚急性期脑实质内出血是否为肿瘤出血时 ,FLAIR序列具有一定诊断价值 (血肿周围低信号环 ) ;FLAIR序列在显示急性蛛网膜下腔出血和脑室出血中明显优于常规 SE序列。结论 FLAIR序列在显示急性蛛网膜下腔出血和脑室出血中 ,具有可靠的诊断价值 ;

脑血管畸形的MRI及MRA诊断

目的：研究脑动静脉畸形与海绵状血管瘤的ＭＲＩ及ＭＲＡ特征，评价不同的成像方法对脑血管畸形的诊断价值。材料与方法：对２１例脑动静脉畸形及６例海绵状血管瘤分别作了常规ＭＲ成像及ＭＲ血管成像，ＭＲＩ采用ＳＥＴ１和ＴｕｒｂｏＳＥＴ２加权序列，ＭＲＡ采用２Ｄ－ＦＬＡＳＨ及３Ｄ－ＦＩＳＰ序列，６例海绵状血管瘤ＭＲＡ仅使用２Ｄ－ＦＬＡＳＨ序列。所有成像以环形激化头线圈在１．０ＴＭＲ仪上完成。结果：Ｔ１及Ｔ２加权成像畸形血管表现为无信号的流空区，ＡＶＭ的内部结构及继发改变ＭＲＩ能很好显示，ＦＩＳＰ－３Ｄ成像，１７例显示供血动脉，１１例引流静脉在２Ｄ－ＦＬＡＳＨ成像时显示。脑海绵状血管瘤在Ｔ１及Ｔ２加权像上表现典型，ＦＩＳＰ－３ＤＭＲＡ未发现有病变血管显示。结论：ＭＲＡ能显示ＡＶＭ的三维解剖结构，采用不同的成像方法，能完整显示供血动脉及引流静脉与瘤巢的关系，ＭＲＡ和ＭＲＩ联合使用有利于对血管结构及周围软组织结构作出全面评价。Ｔ１及Ｔ２加权成像能对脑海绵状血管瘤作出明确诊断，ＭＲＡ并不能提供更多的影像诊断信息。

颅内血管外皮细胞瘤MRI误诊及原因分析

目的探讨颅内血管外皮细胞瘤(HPC)的MRI误诊原因,提高对该病影像诊断认识,以减少误诊率。方法回顾性分析3例MRI误诊但经病理证实的非典型颅内HPC患者临床及影像资料,并查阅相关文献,进行总结、分析。结果 3例均为单发病灶,周围片状水肿带。病例1为顶部镰旁体积较小类圆形肿块,呈等T1稍长T2信号,FLAIR高信号,增强扫描均匀明显强化,肿瘤内部可见迂曲血管影,术前诊断为血管瘤型脑膜瘤;病例2为颞枕部交界区分叶状肿块,呈混杂T1短T2信号,FLAIR为低信号,增强扫描边缘明显强化,其内见斑片状不强化区,邻近颅骨内板受累,信号异常,术前诊断为脑膜瘤;病例3为桥小脑角区类圆形肿块,以稍长T1长T2信号为主,其内可见多发细小分隔,FLAIR为高信号,增强扫描明显不均匀强化,边缘可见流空血管及囊变信号,术前诊断为听神经鞘瘤;3例病理证实均为颅内HPC。结论不典型颅内血管外皮细胞瘤极易误诊,但仔细分析其MRI表现的一些细微征象并结合临床资料可提示诊断。

颅内占位性病变CT、MRI误诊教训及对策

目的 分析影像学误诊的颅内占位性病变CT、MRI表现 ,总结其误诊原因及经验教训。方法 手术 (活检 )病理或临床确诊的CT、MRI曾误诊的颅内占位性病变 61例 ,回顾性分析其征象表现并归纳出五类主要误诊原因。结果 CT、MRI总误诊率为 1 2 .2 %。①部位误导者 49例次 ;②“典型”征误导者 9例次 ;③征象不典型致误者 3 2例次 ;④少见病致误者 2 4例次 ;⑤思维片面致误者 2 5例次。结论 从两个方面降低误诊率 :①认真琢磨基本功 ,不断积累病例诊断正反两方面经验 ,提高发现病变和分析鉴别诊断的能力 ;②影像观察分析要密切结合临床资料 ,注意形态与功能的联系。

脑内结核瘤Gd-DTPA增强MRI表现特点

目的 总结和分析脑内结核瘤在Gd DTPA增强MRI上的表现特点。资料与方法 对 2 4例脑内结核瘤患者进行平扫和Gd DTPA增强扫描 ,比较和分析平扫及增强扫描MRI上的表现特点 ,包括病灶检出数目、分布情况、病灶的形态、信号特点等。结果 结核瘤在Gd DTPA增强扫描自旋回波T1WI上强化明显 ,呈结节样或环形强化 ,有多个病灶聚合成团的特点 ;病变与周边组织分界清楚。结论 脑内结核瘤在增强MRI上有一定的特征性表现 ,Gd DTPA增强MR检查较平扫更敏感 ,能早期发现脑内结核瘤。

颅内结核MRI表现及分型的研究

目的探讨颅内结核MRI的表现及分型。方法回顾性地分析32例颅内结核的MRI表现及分型,全部病例均根据临床表现、PPD试验、胸片、脑脊液检查以及手术病理或药物治疗随访等建立诊断。结果其中结核性脑膜炎19例,颅内结核瘤13例,颅内结核瘤并脑膜炎5例。结核性脑膜炎的MRI主要表现为脑梗塞、脑积水、脑膜及脑基底池的异常增强等。结核瘤MRI可表现为占位、脑水肿,可见钙化,在T2WI上呈低信号以及环形或结节状的异常增强为其特征表现。结论 MRI对颅内结核具有较高的诊断价值,并可对其进行分型指导临床治疗。

自发性低颅压综合征的MRI诊断

目的:探讨自发性低颅压综合征的MRI表现特征。材料和方法:回顾性分析11例自发性低颅压综合征的CT、MRI表现特点。11例均为女性。1例仅行MRI平扫,10例行MRI平扫及增强扫描,其中1例同时行CT平扫。结果:CT表现正常1例。MRI显示额、颞、顶、枕部对称性硬脑膜均匀性增厚9例,伴明显增强11例,合并硬膜下积液6例,硬膜下亚急性期积血3例,"脑下垂"3例。结论:广泛而对称的硬脑膜均匀性增厚、增强是自发性低颅压综合征的特征性影像学表现,MRI有助于诊断自发性低颅压综合征。