Wilms G, Vanderschueren G, Demaerel P H, Smet M H, Van Calenbergh F, Plets C, Goffin J, Casaer P
Department of Radiology, University Hospitals K.U. Leuven, Belgium.
AJNR Am J Neuroradiol. 1993 Jul-Aug;14(4):855-60.
To compare CT and MR in the differentiation of benign enlargement of the subarachnoid spaces and subdural collections in infants with macrocephaly.
MR was performed in 19 infants with macrocephaly, showing bifrontal enlargement of the subarachnoid spaces on CT.
In 11 patients, a single fluid layer could be distinguished on MR of the pericerebral collections, suggesting benign enlargement of the subarachnoid spaces. In eight patients, two separate layers were clearly differentiated, an outer layer that was hyperintense on all sequences and an inner layer with the same intensity as the cerebrospinal fluid. This indicated the presence of subdural collections. These collections were mainly frontal in six and extended over the entire hemisphere in two patients. On CT, these separate lesions were seen only in three patients and missed in three others. In two final patients, CT findings were equivocal with evidence of membrane formation within the hypodense collections. In seven patients with a subdural collection, subdural-external drainage was performed. In three patients, the collection was hemorrhagic. The protein content of the fluid showed a mean of 1381.7 +/- 785.6 mg/dL. The MR and surgical findings of a subdural collection correlated with the absence of a family history of macrocrania, an age under 5 months, and acute clinical signs of vomiting, somnolence, and hypotonia.
MR appears essential in the differential diagnosis between benign enlargement of the subarachnoid spaces and subdural collections in infants.
比较CT和MR在鉴别大头畸形婴儿蛛网膜下腔良性扩张和硬膜下积液方面的作用。
对19例大头畸形婴儿进行MR检查，这些婴儿在CT上显示蛛网膜下腔双侧额叶扩张。
11例患者在脑周积液的MR图像上可分辨出单一液体层，提示蛛网膜下腔良性扩张。8例患者可清晰分辨出两个分离的层面，外层在所有序列上均为高信号，内层与脑脊液信号强度相同，提示存在硬膜下积液。这些积液主要位于额叶的有6例，累及整个半球的有2例。在CT上，这些分离的病变仅在3例患者中可见，另外3例未显示。最后2例患者的CT表现不明确，低密度积液内有膜形成的迹象。7例硬膜下积液患者进行了硬膜下-外引流。3例患者的积液为血性。液体的蛋白含量平均为1381.7±785.6mg/dL。硬膜下积液的MR表现和手术结果与无巨颅症家族史、年龄小于5个月以及呕吐、嗜睡和肌张力低下等急性临床症状相关。
MR对于鉴别婴儿蛛网膜下腔良性扩张和硬膜下积液至关重要。
