RESUMO
PURPOSE: To investigate the magnetic resonance imaging (MRI) images of brain glioma before postoperative radiotherapy, and to provide reference for the delineation of postoperative radiotherapy target area. METHODS: Retrospective analysis was performed on 106 cases of brain glioma confirmed by surgery and pathology in our hospital, including 70 cases of high-grade glioma (HGG) and 36 cases of low-grade glioma (LGG). The MRI images of the lesions within 1 month before and after surgery were analyzed, the apparent diffusion coefficient (ADC) values in the near and far tumor areas were measured, respectively, and the corresponding rADC values were calculated. RESULTS: The incidence of residual tumors of postoperative HGG and LGG was 0, 15.7% (0/36, 11/70), respectively. The incidence of postoperative reactive enhancement was 11.0% and 52.9% (4/36 and 37/70), respectively. About 30.6% and 81.4% (11/36 and 57/70) of patients with adjacent meningeal enhancement were found in the operative area. CONCLUSIONS: The MRI images of HGG and LGG before postoperative radiotherapy had certain characteristics, providing a favorable guidance for the delineation of the target area of radiotherapy and the formulation of treatment plan.
Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Glioma/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Edema Encefálico/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirurgia , Criança , Imagem de Tensor de Difusão , Feminino , Glioma/patologia , Glioma/radioterapia , Glioma/cirurgia , Humanos , Masculino , Meninges/diagnóstico por imagem , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasia Residual/diagnóstico por imagem , Cuidados Pós-Operatórios , Complicações Pós-Operatórias/diagnóstico por imagem , Estudos Retrospectivos , Adulto JovemAssuntos
Coristoma/diagnóstico , Meninges/diagnóstico por imagem , Dermatoses do Couro Cabeludo/diagnóstico , Idoso , Biópsia , Coristoma/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Meninges/patologia , Couro Cabeludo/diagnóstico por imagem , Dermatoses do Couro Cabeludo/patologia , Pele/patologiaRESUMO
Spontaneous intracranial hypotension is an infrequent clinical entity characterized by orthostatic headache, low cerebrospinal fluid pressure, and magnetic resonance imaging findings of diffuse pachymeningeal gadolinium enhancement without previous history of head trauma or lumbar puncture. A 24 year-old healthy woman was referred after having daily headaches for two weeks. She described a headache that occurred soon after assuming an upright position and disappeared after resuming a recumbent position. The cerebrospinal fluid showed pleocytosis primarily lymphocitic, raised protein content and an opening pressure of 20 mm H2O. Magnetic resonance imaging of the head showed diffuse pachymeningeal gadolinium enhancement. Radioisotope cisternography using 99mTc-DTPA confirmed the cerebrospinal fluid leak in the thoracic region. With conservative treatment the patient improved in a few days and the headache disappeared. Radiological findings, together with a compatible clinical condition, help to establish the diagnosis of spontaneous intracranial hypotension and avoid the use of unnecessary clinical investigations.
Assuntos
Pressão do Líquido Cefalorraquidiano , Transtornos da Cefaleia/líquido cefalorraquidiano , Hipotensão Intracraniana/líquido cefalorraquidiano , Adulto , Feminino , Gadolínio , Transtornos da Cefaleia/etiologia , Humanos , Hipotensão Intracraniana/diagnóstico , Imageamento por Ressonância Magnética , Meninges/diagnóstico por imagem , Postura/fisiologia , Cintilografia , Compostos Radiofarmacêuticos , Pentetato de Tecnécio Tc 99m , Tomografia Computadorizada por Raios XRESUMO
El síndrome de hipotensión intracraneal espontánea constituye una entidad clínica cuya principal manifestaciónes la cefalea ortostática. Esta se acompaña de un descenso en la presión del líquido cefalorraquídeo (LCR) y un realce difuso de las paquimeninges evidenciable en la resonancia magnéticaencefálica, sin que medie historia de trauma craneoencefálico o punción lumbar. Mujer de 24 años de edad sinantecedentes de importancia y cefalea holocraneana de carácter opresivo de 15 días de evolución. La mismase exacerbaba con la bipedestación y cedía con el decúbito. En la punción lumbar se observó pleocitosis apredominio linfocítico, hiperproteinorraquia y abundantes glóbulos rojos, siendo la presión de apertura del LCR de 20 mm H2O. La resonancia magnética encefálica mostró un realce paquimeníngeo difuso luego de la administración del gadolinio. La cisternografía radioisotópica con tecnecio 99 señaló el sitio de pérdida de LCR a nivel dorsal alto, confirmándose la sospecha diagnóstica de hipotensión intracraneal espontánea. La pacienterecibió tratamiento médico conservador con evolución clínica favorable. Los hallazgos en los exámenes complementarios y las características clínicas de la cefalea, permitirán confirmar el diagnóstico de hipotensiónintracraneal espontánea, evitando de esta manera la realización de procedimientos innecesarios (AU)
Spontaneous intracranial hypotension is an infrequent clinical entity characterized by orthostatic headache, low cerebrospinal fluid pressure, and magnetic resonance imaging findings of diffuse pachymeningeal gadolinium enhancement without previous history of head trauma or lumbar puncture. A 24 year-old healthy woman was referred after having daily headaches for twoweeks. She described a headache that occurred soon after assuming an upright position and disappeared afterresuming a recumbent position. The cerebrospinal fluid showed pleocytosis primarily lymphocitic, raised proteincontent and an opening pressure of 20 mm H2O. Magnetic resonance imaging of the head showed diffuse pachymeningeal gadolinium enhancement. Radioisotope cisternography using 99mTc-DTPA confirmed the cerebrospinalfluid leak in the thoracic region. With conservative treatment the patient improved in a few days and theheadache disappeared. Radiological findings, together with a compatible clinical condition, help to establish thediagnosis of spontaneous intracranial hypotension and avoid the use of unnecessary clinical investigations (AU)
Assuntos
Humanos , Feminino , Adulto , Pressão do Líquido Cefalorraquidiano , Hipotensão Intracraniana/líquido cefalorraquidiano , Encéfalo/patologia , Quelantes/diagnóstico , Gadolínio/diagnóstico , Cefaleia/diagnóstico , Cefaleia/etiologia , Hipotensão Intracraniana/diagnóstico , Imageamento por Ressonância Magnética , Meninges/diagnóstico por imagem , Postura/fisiologia , Pentetato de Tecnécio Tc 99m/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
El síndrome de hipotensión intracraneal espontánea constituye una entidad clínica cuya principal manifestaciónes la cefalea ortostática. Esta se acompaña de un descenso en la presión del líquido cefalorraquídeo (LCR) y un realce difuso de las paquimeninges evidenciable en la resonancia magnéticaencefálica, sin que medie historia de trauma craneoencefálico o punción lumbar. Mujer de 24 años de edad sinantecedentes de importancia y cefalea holocraneana de carácter opresivo de 15 días de evolución. La mismase exacerbaba con la bipedestación y cedía con el decúbito. En la punción lumbar se observó pleocitosis apredominio linfocítico, hiperproteinorraquia y abundantes glóbulos rojos, siendo la presión de apertura del LCR de 20 mm H2O. La resonancia magnética encefálica mostró un realce paquimeníngeo difuso luego de la administración del gadolinio. La cisternografía radioisotópica con tecnecio 99 señaló el sitio de pérdida de LCR a nivel dorsal alto, confirmándose la sospecha diagnóstica de hipotensión intracraneal espontánea. La pacienterecibió tratamiento médico conservador con evolución clínica favorable. Los hallazgos en los exámenes complementarios y las características clínicas de la cefalea, permitirán confirmar el diagnóstico de hipotensiónintracraneal espontánea, evitando de esta manera la realización de procedimientos innecesarios (AU)
Spontaneous intracranial hypotension is an infrequent clinical entity characterized by orthostatic headache, low cerebrospinal fluid pressure, and magnetic resonance imaging findings of diffuse pachymeningeal gadolinium enhancement without previous history of head trauma or lumbar puncture. A 24 year-old healthy woman was referred after having daily headaches for twoweeks. She described a headache that occurred soon after assuming an upright position and disappeared afterresuming a recumbent position. The cerebrospinal fluid showed pleocytosis primarily lymphocitic, raised proteincontent and an opening pressure of 20 mm H2O. Magnetic resonance imaging of the head showed diffuse pachymeningeal gadolinium enhancement. Radioisotope cisternography using 99mTc-DTPA confirmed the cerebrospinalfluid leak in the thoracic region. With conservative treatment the patient improved in a few days and theheadache disappeared. Radiological findings, together with a compatible clinical condition, help to establish thediagnosis of spontaneous intracranial hypotension and avoid the use of unnecessary clinical investigations (AU)
Assuntos
Humanos , Feminino , Adulto , Pressão do Líquido Cefalorraquidiano , Hipotensão Intracraniana/líquido cefalorraquidiano , Encéfalo/patologia , Quelantes/diagnóstico , Gadolínio/diagnóstico , Cefaleia/diagnóstico , Cefaleia/etiologia , Hipotensão Intracraniana/diagnóstico , Imageamento por Ressonância Magnética , Meninges/diagnóstico por imagem , Postura/fisiologia , Pentetato de Tecnécio Tc 99m/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
The authors describe various new neuroradiological findings in cysticercosis cerebri. Features discussed include: (a) contrast enhancement in cysticercosis, including enhancement of an intraventricular cyst, basal meningeal enhancement, and enhancement in association with granulomatous reaction to cysticercosis; (b) positional cyst alterations, including cyst mobility and positional changes in cyst configuration; (c) neuroradiological features of foramen of Monro obstruction, which may be unilateral or bilateral, and may be due to cysts or adhesions; and (d) unusual angiographic features, including two cases of ring stains which corresponded to ring enhancement on CT, and a mycotic aneurysm associated with cysticercosis. For this study, the authors evaluated 102 cases of cysticercosis; 12 case reports are presented herein.