Department of Radiology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA.
World Neurosurg. 2020 Sep;141:e160-e165. doi: 10.1016/j.wneu.2020.05.042. Epub 2020 May 11.
In adult patients undergoing multidetector computed tomography (CT) of the brain, we observed linear calcification along the deep venous system on thin (<3 mm) sagittal reconstructions. We found no reports of this finding in the velum interpositum (VI) in the imaging literature. We performed a focused examination of the VI on 2 autopsy cases and retrospectively reviewed sagittal, thin-section reconstructions of CT scans of 273 consecutive adult patients.
On 2 routine autopsies of the brain, sampling and histologic evaluation was performed of structures within the VI. A series of 273 unselected, sequentially acquired clinical head CT scans of patients ≥60 years old were retrospectively reviewed on a three-dimensional workstation to determine the incidence of this finding and its correlation with patient age.
In 1 of the autopsy cases, calcified choroid plexus was identified in the region of the VI; this was also visible on the patient's premorbid CT. In the series of CT scans, linear calcification of ≥9 mm along the deep venous system was evident in 24.5% of cases. The median age of the cases without calcifications was 72 years, while the median age of the cases with calcification was 82; this difference was statistically significant (χ, P < 0.0005).
Evidence supports that linear midline calcification along the internal cerebral veins represents age-related, physiologic calcification of extraventricular choroid plexus within the VI. Awareness of this previously unreported finding on CT will prevent mistaking these physiologic calcifications on CT for evidence of underlying venous pathology. This finding provides additional support that the midline choroid plexus lies within the VI rather than in the third ventricle and expands our understanding of the detailed anatomy of the VI.
在接受多层螺旋 CT（MSCT）脑部检查的成年患者中，我们在薄层（<3mm）矢状重建图像上观察到沿深部静脉系统存在线性钙化。我们在影像学文献中未发现中隔帆（IV）内存在这种表现的报道。我们对 2 例尸检进行了 IV 专门检查，并回顾性分析了 273 例连续成年患者 CT 扫描的矢状位、薄层重建图像。
对 2 例常规尸检脑标本进行了 IV 内结构的取样和组织学评估。回顾性分析了 273 例年龄≥60 岁的、未经选择的连续临床头部 CT 扫描系列，在三维工作站上对该发现的发生率及其与患者年龄的相关性进行评估。
在 1 例尸检中，在 IV 区域发现了钙化的脉络丛，这在患者发病前的 CT 上也可见到。在 CT 扫描系列中，24.5%的病例沿深部静脉系统可见≥9mm 的线性钙化。无钙化病例的中位年龄为 72 岁，而有钙化病例的中位年龄为 82 岁；这一差异具有统计学意义（χ²，P<0.0005）。
有证据表明，沿大脑内静脉的线性中线钙化代表了 IV 内脑室外脉络丛的与年龄相关的生理性钙化。在 CT 上认识到这一以前未报道的发现可避免将 CT 上的这些生理性钙化误认为潜在静脉病变的证据。这一发现为中线上的脉络丛位于 IV 内而不是第三脑室提供了更多证据，并扩展了我们对 IV 详细解剖结构的理解。
