一名22歲男子在2個月內(nèi)出現(xiàn)頑固性進行性頭痛。非創(chuàng)傷性頭部CT和對比增強MRI掃描顯示高密度松果體腫塊(圖A和圖B)。動脈造影正常(圖,C和D)。 (a)腦部CT掃描顯示松果體區(qū)有高密度腫塊。(b)T1加權(quán)后對比度MRI顯示對比度增強最小。數(shù)字減影血管造影顯示腫塊區(qū)無動脈(C)或靜脈(D)異常,提示Galen動脈瘤的血栓形成靜脈。 術(shù)中觀察到明顯靜脈引流的腫塊。組織學(xué)證實了Galen相關(guān)血栓動脈瘤靜脈的診斷。 加倫靜脈相關(guān)動脈瘤在成人中很少見。 1常在兒童期出現(xiàn)高輸出量心力衰竭。 2它們表現(xiàn)為等密度到高密度的松果體腫塊,在鈦加權(quán)磁共振成像上具有最小的異質(zhì)性增強,從而模擬松果體腫瘤的放射學(xué)和臨床特征,如我們的病例。 英文原文: Veinof Galen aneurysm mimicking pineal mass in a young adult A 22-year-old man presented with intractableprogressive headaches over 2 months. Noncontrast head CT and contrast-enhancedMRI scan revealed a hyperdense pineal-based mass (figure, A and B). Arteriogramwas normal (figure, C and D). (A)CT scan of brain shows hyperdense mass in pineal region. (B) T1-weightedpostcontrast MRI shows minimal contrast enhancement. Digital subtractionangiogram demonstrates no arterial (C) or venous (D) abnormalities in theregion of mass, implying thrombosed vein of Galen aneurysm. Intraoperatively, a firm mass wasobserved with apparent venous drainage. Histology confirmed thediagnosis of vein of Galen–related thrombosed aneurysm. Vein of Galen–related aneurysms arerare in adults. 1. They oftenpresent in childhood with high-output cardiac failure. 2. Theypresent as isodense to hyperdense pineal mass with minimalheterogeneous contrast enhancement on TI-weighted MRI,thus mimicking radiologic and clinical features of pineal tumors, as in ourcase. |
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