一例酷似脑肿瘤的慢性包裹性脑内血肿：磁共振成像动脉自旋标记的表现
A chronic encapsulated intracerebral hematoma mimicking a brain tumor: Findings on arterial spin labeling of MRI.
作者信息
Kamide Tomoya, Seki Shunsuke, Suzuki Kei-Ichiro, Aoki Takae, Hirano Ken-Ichi, Takahashi Mitsuyuki, Nomura Motohiro
机构信息
Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Japan.
Department of Radiology, Yokohama Sakae Kyosai Hospital, Japan.
出版信息
Neuroradiol J. 2016 Aug;29(4):273-6. doi: 10.1177/1971400916648334. Epub 2016 May 6.
BACKGROUND
Intracerebral hematoma usually resolves spontaneously. Chronic encapsulated intracerebral hematoma is rare and mimics a brain tumor.
CASE DESCRIPTION
A 50-year-old man had developed intracerebral hematoma in the right temporal lobe. Computed tomography (CT) showed the gradually decreasing density of the hematoma. However, the hematoma did not decrease in size and it showed ring enhancement on contrast-enhanced CT for more than 1 year. Magnetic resonance imaging (MRI) revealed a lesion content showing a high intensity on both T1- and T2-weighted images with ring enhancement. The lesion was diagnosed as a chronic encapsulated intracerebral hematoma developing from an acute hematoma. Arterial spin labeling of MRI showed decreased blood perfusion even in the enhanced capsule, being different from findings of a cystic brain tumor.
CONCLUSION
Arterial spin labeling might be a useful modality to distinguish a chronic encapsulated intracerebral hematoma from a cystic hypervascular brain tumor.
背景
脑内血肿通常会自发消退。慢性包裹性脑内血肿较为罕见，且类似脑肿瘤。
病例描述
一名50岁男性在右侧颞叶出现脑内血肿。计算机断层扫描（CT）显示血肿密度逐渐降低。然而，血肿大小并未减小，且在增强CT上显示环形强化超过1年。磁共振成像（MRI）显示病灶内容物在T1加权和T2加权图像上均呈高强度且有环形强化。该病灶被诊断为由急性血肿发展而来的慢性包裹性脑内血肿。MRI的动脉自旋标记显示即使在强化的包膜内血流灌注也降低，这与囊性脑肿瘤的表现不同。
结论
动脉自旋标记可能是一种有助于区分慢性包裹性脑内血肿与囊性高血管性脑肿瘤的有用方法。
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