Tsutsumi Satoshi, Ono Hideo, Yasumoto Yukimasa
Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan.
Surg Radiol Anat. 2017 Jul;39(7):747-751. doi: 10.1007/s00276-016-1806-7. Epub 2017 Jan 5.
The tuber cinereum (TC) comprises the hypothalamic gray matter that forms the anterior portion of the third ventricle floor. However, since it has been rarely documented in previous neuroimaging investigations, the aim of the current study was to explore the morphology of the TC using magnetic resonance imaging (MRI).
Ninety-two patients were enrolled in this study. Following initial examination with conventional MRI sequences, a contrast study using intravenous gadolinium injection was performed in thin-sliced sections.
The TC, which was commonly defined as a linear, enhancing structure on the midsagittal section, was identified in all 92 cases. In 83% of cases, the third ventricle floor had a gentle inflection at the junctional site between the median eminence and TC. The angle formed between the line parallel to the TC and the horizontal line showed considerable variability, which ranged from 0.5° to 56°. Furthermore, a non-enhancing segment of variable length was identified in the posterior-most TC. In 11% of cases, the midline TC was enhanced over the whole length.
Since the most part of the midline TC was enhanced with intravenous gadolinium injection, it may function as a circumventricular organ. The TC should be evaluated with contrast sagittal MRI prior to performing surgery with management of the anterior third ventricle floor.
灰结节(TC)由构成第三脑室底部前部的下丘脑灰质组成。然而,由于在以往的神经影像学研究中对其记录较少,本研究旨在利用磁共振成像(MRI)探索灰结节的形态。
本研究纳入了92例患者。在使用传统MRI序列进行初步检查后,对薄层切片进行静脉注射钆对比剂研究。
在所有92例病例中均识别出灰结节,其在正中矢状面上通常被定义为线性强化结构。在83%的病例中,第三脑室底部在正中隆起与灰结节的交界处有轻度弯曲。与灰结节平行的线与水平线所形成的角度变化较大,范围为0.5°至56°。此外,在灰结节最靠后的部分发现了一段长度可变的无强化区域。在11%的病例中,中线灰结节全长强化。
由于中线灰结节的大部分在静脉注射钆后强化,它可能作为一个室周器官发挥作用。在对第三脑室底部前部进行手术治疗前,应通过钆对比剂矢状面MRI对灰结节进行评估。