颅内囊肿病理-影像对照和诊断 ppt课件.ppt

Neurocysticercosis Imaging When cyst degeneration begins (colloidal-vesicular stage) and host inflammatory response ensues, pericystic edema and cyst wall enhancement are present. Cyst fluid is hyperintense to CSF on MR images during this stage Neurocysticercosis Imaging In the healing, or granular nodular stage, nonenhanced CT scans show an isoattenuated cyst with a hyperattenuated calcified scolex. Surrounding edema is still present, and enhancement persists The residual cyst is isointense to the brain on T1WI and iso- to hypointense on T2WI. Nodular or micro-ring enhancement is common at this stage, suggesting granuloma. Neurocysticercosis Imaging target or bulls eye appearance Multifocal lesions and lesions in different stages of development are common Transverse T1-weighted MR image shows innumerable tiny low-signal-intensity neurocyticercosis cysts in brain parenchyma and subarachnoid spaces. Most contain small dot that represents the scolex (arrows) Neurocysticercosis Differential Diagnosis Abscess: T2-hypointense rim, whereas neurocysticercosis cysts are typically isointense except when they are in the ventricles where the rim is hyperintense on FLAIR images Tuberculosis: often occur with meningitis, are rarely cystic, and often profoundly hypointense on T2WI Enlarged PVSs: same appearance as CSF at all MR sequences and do not enhance, none of these cystic lesions has the characteristic cyst with dot appearance hydatid cysts Pathologic Findings Caused by the larval stage of Echinococcus granulosus（细粒棘球蚴） Rare, seen in only 2% of all cases The most common location is the hemispheric parenchyma, particularly in the perfusion territory of the middle cerebral artery The subarachnoid spaces are another common site of involvement hydatid cysts Pathologic Findings Hydatid cysts are usually spherical, solitary, and unilocular They grow slowly and are typically large, averaging 4–10 cm in diameter The cysts contain translucent fluid and may also contain d