朗读老师:Jane医院
翻译老师:章维昆明医院
审校老师:姜春医院
History:A33-year-oldwomanstatuspostmotorvehiclecollision.
HeadCTwithoutIVcontrastwasperformed.
rainMRIwithoutIVcontrastwasperformed.
33岁女性车祸后
病史,CT及核磁影像
病史:33岁女性,在发生机动车辆碰撞事故后,接受了颅脑CT平扫检查及核磁检查,
Findings
CT:Therearemultipleareasofintra-axialhyperattenuationwithprominentlesionsintheleftposteriorcentrumsemiovaleandtheleftpons.Thelargestlesionisalongtheleftfrontalconvexityandcontainsinterspersedcalcifications.
影像表现
CT:左侧半卵圆中心后份、桥脑左份可见多发明显高密度病灶。最大的病灶出现在左侧额叶凸面,其内多发点片状钙化。
MRI:Therearemorethan20supratentorialandinfratentoriallesionsofvariablesizeandT1/T2hyperintensities.AllofthelesionsexhibitincreasedsusceptibilityonGREandareinkeepingwithcerebralcavernousmalformations.
磁共振:幕上、幕下可见20多个大小不一的T1、T2高信号病灶。所有的病灶在梯度回波序列上都表现为磁敏感性增强,和脑海绵状血管瘤表现一致。
Differentialdiagnosis
Cerebralcavernousmalformations
Cerebralamyloidangiopathy
Diffuseaxonalinjury
Hemorrhagicmetastaticdisease
Diagnosis:Cerebralcavernousmalformations
鉴别诊断
脑海绵状血管瘤畸形
脑淀粉样血管病
脑实质弥漫性轴索损伤
出血性转移性疾病
影像诊断
脑海绵状血管瘤畸形
Cerebralcavernousmalformations
海绵状血管瘤
Pathophysiology
Cerebralcavernousmalformations(cavernomas)areclustersof"lowflow"vascularchannelswithoutbrainparenchymainterveningbetweenthesinusoidalvessels.Pathogenesisofcavernomasisnotwellestablished.Amajorityofcavernomasaresporadic,butupto20%followafamilial,autosomaldominantinheritancepatterncharacterizedbythepresenceofmultiplecavernomasinasinglepatient.Thishasledtotheidentificationofthreehomologicallydistinctgenesresponsibleforcavernomadevelopment.
病理生理
脑海绵状血管畸形(海绵状血管瘤)是成簇状的低流量血管管道,簇状血管间没有脑实质。海绵状血管瘤的发病机制尚不明确。大多数海绵状血管瘤是散发性的,但高达20%的患者遵循家族性、常染色体显性遗传模式,以单个患者存在多个海绵状血管瘤为特征。以上特征证明海绵状血管瘤的发生、发展是由三个同源的不同基因负责。
Epidemiology
Cavernousmalformationsarethesecondmost