双语病例丨颅内多发海绵状血管瘤CTMR

往期相关链接:

颅内动静脉畸形、动脉瘤、海绵状血管瘤

History:A36-year-oldmanpresentswithnew-onsetseizures.

病史:36岁男性,癫痫发作。

AheadCTscanwasperformed.行颅脑CT平扫。

MRimages

Acontrast-enhancedMRIscanofthebrainwasperformed.Inorder:AxialT-weightedfluid-attenuatedinversion-recovery(FLAIR),axialdiffusion-weighted(DWI),twoaxialgradient-recalledecho(GRE),axialT1-weightedpostcontrast,andcoronalT1-weightedpostcontrastimages.

行颅脑增强MR,各序列如下面图中所示。

Findings

CT:Therearemultiplefocalhyperdenselesions,includingalargelesionwithfociofcalcificationintherightcoronaradiata.Thereisnoassociatedmasseffect.

MRI:TherearemultipleThypointensebrainlesionswithmarkedsusceptibilityartifact.ThereisnosignificantenhancementandnosurroundingFLAIRsignal.Thereisanabnormaldrainingveinfromtherightcoronaradiatalesion,consistentwithadevelopmentalvenousanomaly.

影像表现:

CT:脑内多发局限性高密度灶,其中右侧放射冠一较大病灶可见钙化,无明显占位效应。

MRI:脑内多发T低信号灶,可见明显磁敏感伪影,无明显强化及周围水肿,右侧放射冠区病灶见一异常引流静脉,符合发育性静脉异常表现。

Differentialdiagnosis

Amyloidangiopathy

Hypertensivebleeds

Hemorrhagicneoplasm

Cavernomas

Diagnosis:Multiplehereditarycavernomas

鉴别诊断:

淀粉样血管病

高血压性脑出血

肿瘤合并出血

海绵状血管瘤

诊断:多发性遗传性海绵状血管瘤

Keypoints

Cavernousmalformations

海绵状血管瘤

Pathophysiology病理生理学

Cavernousmalformations,alsotermedcavernomas,arebenignvascularhamartomas.海绵状血管畸形,也称海绵状血管瘤,是良性的血管错构瘤。

Theyoftenhemorrhage,creatingacharacteristicimagingappearance.病灶常出血,具有特征性的影像表现。

Themost


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