Preul M C, Villemure J G, Leblanc R, del Carpio-O'Donovan R
Divisions of Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.
Can J Neurol Sci. 1992 Aug;19(3):376-82.
We report experience with 11 patients misdiagnosed for years, on the basis of computed tomography (CT) and angiography, as harbouring brainstem tumours in whom magnetic resonance imaging (MRI) demonstrated cavernous angiomas. Seven had undergone external irradiation, 2 had a ventriculo-peritoneal shunt, 2 developed aseptic femur necrosis following corticosteroid treatment, 1 had undergone a biopsy with a pathological diagnosis of glioma. CT had depicted ill-defined, hyperdense, faintly enhancing lesions. Angiography was normal, or showed an avascular mass or subtle venous pooling. MRI delineated discrete lesions, typical of cavernous angiomas, with a mixed hyperintense, reticulated, central core surrounded by a hypointense rim. Six patients subsequently underwent stereotactic radiosurgery without changes in clinical status or lesion. Although hemorrhagic neoplasms may mimic the clinical course and MRI appearance of cavernous angiomas, MRI is useful in the diagnosis of brainstem cavernous angiomas and should be performed in patients with suspected brainstem tumours.
我们报告了11例多年来被误诊的患者的情况。基于计算机断层扫描（CT）和血管造影，这些患者被误诊为患有脑干肿瘤，而磁共振成像（MRI）显示为海绵状血管瘤。其中7例接受了外照射，2例进行了脑室-腹腔分流术，2例在接受皮质类固醇治疗后发生无菌性股骨坏死，1例接受了活检，病理诊断为胶质瘤。CT显示边界不清、高密度、轻度强化的病变。血管造影正常，或显示无血管肿块或轻微静脉池。MRI显示出典型的海绵状血管瘤离散病变，中央为混合高信号、网状核心，周围有低信号边缘。6例患者随后接受了立体定向放射外科治疗，临床状态和病变均无变化。尽管出血性肿瘤可能模仿海绵状血管瘤的临床病程和MRI表现，但MRI对脑干海绵状血管瘤的诊断很有用，对于疑似脑干肿瘤的患者应进行MRI检查。
