Gradowska Kinga, Czech-Kowalska Justyna, Jurkiewicz Elżbieta, Komornicka Justyna, Dobrzańska Anna
Department of Neonatology, Neonatal Pathology and Intensive Care, Children's Memorial Health Institute, Warsaw, Poland.
Pol J Radiol. 2011 Oct;76(4):63-8.
Central nervous system lipomas are rare tumours. In most of the cases they are located in corpus callosum of the brain. The ultrasonographic image of lipomas tends to be quite characteristic. Final diagnosis is however done on a basis of brain resonance. The purpose of this work is to present proceeding in case of central nervous system lipomas with particular attention to diagnostic imaging. This work is based on own research.
There are eight patients with central nervous system lipomas described in this work. The ultrasonographic imaging performed upon patients' birth revealed features of agenesis of corpus callosum with presence of hyperechoic structure in the area of median line within corpus callosum. This image correlated with Nuclear Magnetic Resonance examination results. Our research confirms that patients with central nervous system lipomas represent rare diagnostic and therapeutic cases. Due to characteristic results of ultrasonographic imaging of the brain, recognition of agenesis of corpus callosum would not cause difficulties. However the presence of hyperechoic structure without vascular flow which may suggest lipomas of corpus callosum would require final verification of the diagnosis and wider assessment of brain with NMR examination. We did not recognize any relation between corpus callosum pathology and neuroinfection of cytomegalovirus etiology. In all of the eight research cases there were malformations diagnostics conducted. There were genetic irregularities in case of two of the neonates only. Until today, all of the patients remain under neurological care. Their psychomotor development is regularly controlled.
Taking into consideration that numerous malformations occur altogether with brain lipomas, it is recommended to conduct appropriate diagnostics, to inform parents on an essence of diagnosis and on necessity of observing child's psychomotor development. Obviously, it is crucial to secure a patient with paediatric and neurological care.
中枢神经系统脂肪瘤是罕见肿瘤。大多数情况下,它们位于脑胼胝体。脂肪瘤的超声图像往往具有相当的特征性。然而,最终诊断是基于脑部磁共振成像。本研究的目的是介绍中枢神经系统脂肪瘤的诊疗过程,尤其关注诊断性影像学检查。本研究基于自身研究。
本研究描述了8例中枢神经系统脂肪瘤患者。患者出生时进行的超声成像显示胼胝体发育不全的特征,胼胝体中线区域存在高回声结构。这一图像与核磁共振检查结果相符。我们的研究证实,中枢神经系统脂肪瘤患者代表罕见的诊断和治疗病例。由于脑部超声成像的特征性结果,识别胼胝体发育不全不会造成困难。然而,存在无血流的高回声结构可能提示胼胝体脂肪瘤,这需要通过核磁共振检查对诊断进行最终核实,并对脑部进行更广泛的评估。我们未发现胼胝体病变与巨细胞病毒病因的神经感染之间存在任何关联。在所有8例研究病例中均进行了畸形诊断。仅2例新生儿存在基因异常。直至今日,所有患者仍接受神经科护理。他们的精神运动发育得到定期监测。
鉴于脑脂肪瘤常伴有多种畸形,建议进行适当诊断,告知家长诊断的本质以及观察孩子精神运动发育的必要性。显然,为患者提供儿科和神经科护理至关重要。