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腦海綿狀畸形（Cavernoma）
最後更新：2022年1月10日
目錄：腦海綿狀畸形（Cavernoma）
Figure 1: MR images demonstrate a large parenchymal lesion centered in the right cerebellar hemisphere causing significant adjacent mass effect and complete obstruction of the fourth ventricle. There is central reduced diffusivity (top left and top right) and a large amount of susceptibility (blooming) artifact on SWI (middle left) secondary to recent hemorrhage. (Middle Right) A FLAIR image demonstrates a moderate amount of hyperintense signal, which is typically seen only in lesions that have recently hemorrhaged or occasionally when the lesions are large and have a significant mass effect. (Bottom) Somewhat atypical is the degree of heterogeneous enhancement on postcontrast imaging.
描述
- Benign vascular lesion with a classic imaging appearance
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地圖集Choice錐形帕蒂集合
Low-profile for maximal visualization and protection
專為缺亂手術設計的錐形形狀
Unparalleled flexibility and non-stick features
Pathology
- Blood cavities surrounded by a single layer of endothelium without muscular tissue or intervening brain parenchyma
- Two types
- Sporadic and familial
臨床表現
- Symptoms
- Seizure, hemorrhage, focal progressive neurologic deficits, and headaches
- 〜25％無症狀
- Age
- Peak presentation in middle age
- 家族畸形畸形往往呈現早期
- Gender
- No gender predilection
- Associations
- Developmental venous anomaly(DVA)
- Superficial siderosis (hemosiderin deposition on the surface of the brain)
- Cutaneous abnormalities
- Café au lait spots
- Hyperkeratotic capillary-venous malformation
Imaging
- 一般的
- 經典的“爆米花”外觀，T2加權成像完全低音圖
- Modality specific
- CT
- Often negative
- 如果是陽性，將看到一個明確定義的高陣容病變，相關的鈣化，表現出很少沒有增強
- MRI.
- T1WI and T2WI
- “Popcorn ball” appearance with low signal rim and mixed internal signal demonstrating differing stages of hemorrhage
- Surrounding edema present only if recent hemorrhaging has occurred
- T2*
- Hypointense signal associated due to hemosiderin and calcification
- Contrast
- Minimal or no contrast enhancement, unless associated with a developmental venous anomaly
- T1WI and T2WI
- 傳統血管造影
- 通常是正常的
- Occasional slow intralesional flow without arteriovenous shunting and venous pooling
- CT
- Imaging recommendations
- MRI相反
- Contrast used to exclude associated anomalies
- T2 * / SWI / GRE序列與長TE
- 模仿
- 當最近出血時，難以區分潛在的出血性腫瘤或動脈畸形。隨訪成像通常是監測血液產品的演變並評估底層腫瘤的必要方法。
For more information, please see the corresponding chapter inRadiopaediaand the海綿狀畸形chapter within theCerebral Vascular Diseasessubvolume withinThe Neurosurgical Atlas。
Contributor: Sean Dodson, MD
References
Brunereau L, Labauge P, Tournier-Lasserve E, et al. Familial form of intracranial cavernous angioma: MR imaging findings in 51 families.Radiology。2000;214:209–216.doi.org/10.1148/radiology.214.1.r00ja19209
Huisman TAGM. Tumor-like lesions of the brain.Cancer Imaging。2009;9:S10–S13.doi.org/10.1102/1470-7330.2009.9003
Meng G, Bai C, Yu T, et al. The association between cerebral developmental venous anomaly and concomitant cavernous malformation: an observational study using magnetic resonance imaging.BMC Neurol。2014;14:50.doi.org/10.1186/1471-2377-14-50
Moore SA, et al. Long-term natural history of incidentally discovered cavernous malformations in a single-center cohort.J Neurosurg。2014;120:1188–1192.doi.org/10.3171/2014.1.JNS131619
Sohn CH, Kim SP, Kim IM, et al. Characteristic MR imaging findings of cavernous hemangiomas in the cavernous sinus.AJNR Am J Neuroradiol。2003; 24：1148-1151。
Tamburrini G, Iannelli A, Caldarelli M, et al. Large cerebral cavernoma mimicking a brain tumor.Pediatr Neurosurg。2002;37:105–106.doi.org/10.1159/000065114
Yun TJ, Na DG, Kwon BJ, et al. A T1 hyperintense perilesional signal aids in the differentiation of a cavernous angioma from other hemorrhagic masses.AJNR Am J Neuroradiol2008;29:494–500.doi.org/10.3174/ajnr.A0847
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