Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University, No. 246 Heping Road, Hefei, 230011, China.
BMC Ophthalmol. 2022 Mar 1;22(1):96. doi: 10.1186/s12886-022-02328-8.
The movement of intraventricular silicone oil observed in the supine position is extremely rare. Herein, we describe a patient who presented with dynamically moving silicone oil particles in the ventricle when changing position and provide an updated review of this phenomenon.
We report a case of a 70-year-old woman who presented with intraventricular hyperdensities that were occasionally found on brain computed tomography (CT). Initial nonenhanced brain CT demonstrated nondependent hyperdensities in the bilateral anterior horns of the lateral ventricles, the third ventricle, and the right suprasellar cistern, mimicking an intraventricular hemorrhage. Further brain magnetic resonance imaging (MRI) in the supine position revealed abnormal signals in the bilateral anterior horns of the lateral ventricles, the posterior horn of the right lateral ventricle, the third ventricle, the right suprasellar cistern, and the bilateral eyeballs, with isosignal intensities surrounded by low-signal chemical shift artifacts on T-weighted imaging and variable signals (hypo- or hyperintensity) on T-weighted imaging. The lesion in the anterior horn of the right ventricle largely moved to the posterior horn of the ipsilateral ventricle. The final craniocervical CT angiography showed that the lesion in the posterior horn had moved back to the anterior horn of the right lateral ventricle. These features were consistent with intraventricular silicone oil migration. The final spinal MRI did not demonstrate a migration of silicone oil into the spinal subarachnoid space.
This case report describes a dynamic process of silicone oil displacement in the supine position and provides a comprehensive imaging presentation. The moving pattern and a characteristic chemical shift artifact on MRI are key to the diagnosis and may help prevent unnecessary examinations or intervention.
在仰卧位时观察到脑室中的硅油运动极为罕见。在此，我们描述了一位患者在改变体位时出现脑室中硅油颗粒动态移动的情况，并对这一现象进行了更新的综述。
我们报告了一例 70 岁女性患者，其脑部计算机断层扫描（CT）偶尔发现脑室中有高密度影。初始非增强脑部 CT 显示双侧侧脑室前角、第三脑室和右侧鞍上池存在非依赖性高密度影，类似于脑室出血。进一步的仰卧位脑部磁共振成像（MRI）显示双侧侧脑室前角、右侧侧脑室后角、第三脑室、右侧鞍上池和双侧眼球存在异常信号，T1 加权成像呈等信号强度，周围环绕着低信号化学位移伪影，T2 加权成像呈可变信号（低或高信号）。右侧心室前角的病变大部分移动到同侧心室的后角。最终的颅颈 CT 血管造影显示，后角的病变已返回右侧侧脑室前角。这些特征与脑室中的硅油迁移一致。最终的脊髓 MRI 未显示硅油迁移到脊髓蛛网膜下腔。
本病例报告描述了仰卧位时硅油置换的动态过程，并提供了全面的影像学表现。MRI 上的移动模式和特征性化学位移伪影是诊断的关键，有助于避免不必要的检查或干预。
