Tsurushima H, Kamezaki T, Tomono Y, Nose T
Department of Neurosurgery, Ibaraki Seinan Medical Center Hospital.
Neurol Med Chir (Tokyo). 1997 Nov;37(11):861-4. doi: 10.2176/nmc.37.861.
A 70-year-old female presented with symptoms of right-sided trigeminal neuralgia. Computed tomography showed a high-density mass in the prepontine cistern without enhancement. Magnetic resonance (MR) imaging showed the mass as heterogeneous with variable but largely high-signal intensity on T1-weighted images and low-signal intensity on T2-weighted images. At surgery, the lesion was found to be an epidermoid cyst filled with old blood and lipid debris. The high-signal intensity on the T1-weighted images may reflect lipid or methemoglobin with the low intensity on T2-weighted images representing hemosiderin. Most intracranial epidermoid cysts appear as low-intensity lesions on T1-weighted images and high-signal intensity on T2-weighted images. Typical MR imaging findings are neither specific for nor constant with epidermoid cysts, requiring critical differential diagnosis.
一名70岁女性出现右侧三叉神经痛症状。计算机断层扫描显示脑桥前池有一个高密度肿块，无强化。磁共振成像显示该肿块不均匀，在T1加权图像上信号强度可变但大多为高信号，在T2加权图像上为低信号。手术中发现病变为一个充满陈旧血液和脂质碎片的表皮样囊肿。T1加权图像上的高信号强度可能反映脂质或高铁血红蛋白，而T2加权图像上的低强度代表含铁血黄素。大多数颅内表皮样囊肿在T1加权图像上表现为低强度病变，在T2加权图像上为高信号强度。典型的磁共振成像表现对表皮样囊肿既不具有特异性也不恒定，需要进行严格的鉴别诊断。
