脑血管周围间隙(V-R间隙)的MRI诊断和鉴别诊断.pptVIP

粘多糖增多症(mucopolysaccharidosis，MPS) 2岁男孩。双侧半球见扩大的VRS，FLAIR见病灶周围高信号影，提示为非正常扩大的VRS。双额叶蛛网膜下腔增宽。 脑室周围白质软化症(periventricular leukemialacia,PVL) PVL是一种继发性脑白质病，多见于早产儿及有窒息史的足月儿，主要与缺血缺氧有关，是造成早产儿脑瘫的主要原因。 男孩，3岁。发育落后。双侧脑室三角区附近分布的病灶，FLAIR上周围可见高信号改变。 脑囊虫病 17岁男孩，脑实质囊尾蚴感染，T1WI可见偏心的头节 蛛网膜囊肿 鉴别要点：发生部位不同 神经上皮囊肿 多不易鉴别 脉络膜裂囊肿 脉络膜裂位于海马回与下丘脑之间，内侧通于环池，外侧为侧脑室下角，前面是海马沟及杏仁体，后部与海马沟交通。 脉络膜裂囊肿信号同其他部位的蛛网膜囊肿：长T1,长T2信号，FLAIR呈低信号，与脑脊液信号相仿。 冠状位上多呈“双凸透镜”形，显示最好; 矢状位上，脉络膜裂与海马沟交通，类似斜卧的‘入”字，所以脉络膜裂囊肿常沿脉络膜裂、海马沟成角，呈一箭头样改变或颞叶内侧卵圆形或纺锤形囊肿，其长轴沿后上至前下斜行为特征性结构 脉络膜裂囊肿 脉络膜裂囊肿 囊性肿瘤 15岁女孩。右侧丘脑毛细胞型星形细胞瘤 End！ Figure 2. Drawing shows a cortical artery with a surrounding VR space crossing from the subarachnoid and subpial spaces through the brain parenchyma. The magnified view on the right shows the anatomic relationship between the artery, VR space, subpial space, and brain parenchyma Figure 7. Type III VR space in a 25- year-old man. (a) Axial proton-density– weighted image (2620/100) shows a hyperintense spot in the brainstem (arrow). (b) Axial FLAIR image (7292/ 120) obtained at the same level shows that the spot has CSF-like content without abnormal surrounding signal intensity (arrow). These findings confirm that the spot is a VR space. Figure 8. Type III VR spaces in a 68-year-old man. (a) Axial proton-density–weighted image (2382/100) shows multiple punctate hyperintense areas in the brainstem (arrow). (b) Close-up T2-weighted image (4615/120) clearly shows the fine punctate pattern. (c) Axial FLAIR image (6609/100) shows the CSF-like content of the dots (arrow). No surrounding high signal intensity is seen. The typical configuration and the fact that no high signal intensity is seen on the FLAIR image confirm that the dots are VR spaces. T1, PD, T2 Type III型 * 不典型表现 * 偶尔，VRS明显增大，表现出占位效应，类似囊样占位 巨大的VRS常见于中脑-丘脑区域，可以压迫第三脑室引起脑积水 VRS扩大与神经疾病 MRI研究已经证实，脑白质病变增加与老年人认知功能下降有着密切关系。而VRS扩大与脑白质病变有着一些相似的危险因素，VRS的大小和数目与脑白质病变的范围相关。 研究发现，VRS扩大的数目增加与认知功能下降相关，尤其是非文字想象和视空间能力。 因此，基于MRI的脑白质病变计分评价中，还应