Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China.
Chongqing Clinical Research Centre of Imaging and Nuclear Medicine, Chongqing, 400042, China.
BMC Neurol. 2022 Dec 2;22(1):448. doi: 10.1186/s12883-022-02993-8.
Inflammatory myofibroblastic tumor (IMT) is a rare central nervous system (CNS) tumor. We first report a rare case of IMT in the lateral ventricle and describe the magnetic resonance imaging (MRI) findings of the tumor with an emphasis on the advanced MRI features.
A 49-year-old female patient with headaches and blurred vision for 2 months. Brain MRI revealed a well-circumscribed, lobulated mass occupying the left lateral ventricle trigone, with marked perilesional brain edema. The tumor showed heterogeneous significant hyperintensity on T2-weighted imaging (T2WI) and hypointensity on T1-weighted imaging (T1WI). After the administration of gadolinium, the mass exhibited marked contrast enhancement and the halo sign was observed. On advanced MRI, the lesion showed decreased perfusion on perfusion MRI and reduced diffusion on diffusion-weighted imaging (DWI). On susceptibility-weighted imaging (SWI), there was a punctate low signal intensity in the tumor. The patient underwent surgical resection of the mass and a pathological examination confirmed the lesion to be an inflammatory myofibroblastic tumor with negative expression of anaplastic lymphoma kinase (ALK). This patient had remained healthy without evidence of recurrence during a 20-month follow-up.
On MRI, marked perilesional brain edema, significant hyperintensity on T2WI, hypoperfusion on perfusion MRI but with an obvious enhancement, no diffusion restriction on DWI, and halo sign may be the characteristic findings of intraventricular IMT. The advanced MRI characteristics could provide abundant information to reflect the histological features and physiological metabolic characteristics of the tumor.
炎性肌纤维母细胞瘤（IMT）是一种罕见的中枢神经系统（CNS）肿瘤。我们首次报道一例罕见的侧脑室 IMT，并描述了肿瘤的磁共振成像（MRI）表现，重点介绍了高级 MRI 特征。
一名 49 岁女性患者，头痛和视力模糊 2 个月。脑部 MRI 显示边界清楚的分叶状肿块占据左侧侧脑室三角区，伴有明显的周围脑水肿。肿瘤在 T2 加权成像（T2WI）上呈不均匀的显著高信号，在 T1 加权成像（T1WI）上呈低信号。钆增强后，肿块呈明显对比增强，观察到晕环征。在高级 MRI 上，病变在灌注 MRI 上显示灌注减少，在弥散加权成像（DWI）上显示弥散受限。在磁敏感加权成像（SWI）上，肿瘤内有散在的低信号强度。患者接受了肿块的手术切除，病理检查证实病变为炎性肌纤维母细胞瘤，ALK 表达阴性。该患者在 20 个月的随访中保持健康，无复发迹象。
在 MRI 上，明显的周围脑水肿、T2WI 上的显著高信号、灌注 MRI 上的低灌注但明显增强、DWI 上无弥散受限和晕环征可能是脑室 IMT 的特征性表现。高级 MRI 特征可以提供丰富的信息，反映肿瘤的组织学特征和生理代谢特征。
