patología ventricular intracraneal
TRANSCRIPT
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PATOLOGÍA VENTRICULARCEREBRAL
R2 – RADIODIAGNÓSTICOCAUSAL
MASAS INTRAVENTRICULARESMASAS INTRAVENTRICULARES
CAROLINA VARGAS JIMÉNEZ CAROLINA VARGAS JIMÉNEZ R2-RADIODIAGNÓSTICOR2-RADIODIAGNÓSTICO
CAUSALCAUSAL
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Schematic 3D representation of the ventricular system, viewed in the sagittal plane, demonstrates the normal appearance and communicating pathways of the cerebral ventricles.
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HIDROCEFALIA
OBSTRUCTIVA
Proximal Luschka, Magendie
- Aguda:Dedos de LCRHaloAbalonamiento
- Crónica (compensada)
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HIDROCEFALIAHIDROCEFALIA
T2 - FLAIR
T2
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NEOPLASIAS INTRAVENTRICULARES
EPENDIMOMA:- Jóvenes- Infratent. +++:
Niños: 6 a. - Supra:
18-24 a-- Componente
quístico- calcio- sangre
- LCR- II - Anaplásico III
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EPENDIMOMA
EPENDIMOMA:- TC: Hipo-Iso- T1: Iso- Hipo- T1 + C: Heter.- T2: Iso – Hiper- ADC : +/-- SSM: Ca -
Sangre
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EPENDIMOMA
EPENDIMOMA:- TC: Hipo-Iso- T1: Iso- Hipo- T1 + C: Heter.- T2: Iso – Hiper- ADC : +/-- SSM: Ca –
Sangre- MRS: ↓ NAA, ↑ Cho
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SUBEPENDIMOMA
• Incidental• ♂ > 15 A.♀• 4to (60%) - VL-
3ro. • < 2 cms. • Bien
diferenciados.
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- TC: Hipo-Iso
- T1: Iso- Hipo
- T1 + C: Escaso- dd. TSCG
- T2: Hiper (< edema)
- SSM: Ca – Sangre
SUBEPENDIMOMA
T2 - FLAIR T2
T1 + C
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NEUROCITOMA• Origen?• ♂ = 30 A.♀• Pista: burbuja• VL 3ro• 50-70% ca.• Sangrado • Sintomáticos• Grado II.
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NEUROCITOMA-TC: Iso-Hiper-T1: Iso-T1 + C: Het. Mod-intenso-T2: Iso -Hiper Edema ady. -SRM:-↓ NAA, ↑ Cho- Gly o ML (3,55ppm)
T1 DWI
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NEUROCITOMA
T1+ C
T2
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• ET- Patognomónico• Nódulo
subependimario• 1-50 a (media 11a)• Benignos.• Adyacentes Monro• Ca +++ No sangran.
TSCG
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TSCG• TC: hipo/iso.• T1: hipo/iso• T2: iso/hiper• T1+C: Ávida• DWI: valores de ADC menores < NS.• MRS:↓ NAA, ↑ Cho
T2 - FLAIR
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TSCG
T1+C T1
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NEOPLASIAS PLEXO COROIDEO• Papiloma plexo coroideo (I)• PPC Atípico (II)• CPC (III) irregulares- heterogéneos- invasivos.
PEDICULADOS- VASCULARESHEMORRAGIAS - QUISTES
• Edad pediátrica- HIDROCEFALIA• ♂ = Excepto 4to Vent. ♀• Li Fraumeni- Aicardi.• VL (atrio) IV
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• T1 iso/hipo T1.• T2 iso/hiper• T1 + C: intenso.• DWI: No restringen• PRM: Flujo arterial alto.• ERM:
PPC ↓ ↓ NAA, ↑ ChoCPC ↑ Lactato, ML
NEOPLASIAS PLEXO COROIDEO
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NEOPLASIAS PLEXO COROIDEO
T1+ CT2
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MENINGIOMA
• ♀ > 30-50A.♂• Transformación sarcomatosa• NFM II• VL• Ca- 50%- quistes-hemorragia
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MENINGIOMA
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MENINGIOMA
• TC iso/hiper• RM-T1: iso/hipo-T1 + C:AVIDO-T2:Iso/hiper-DWI:Restricción variable
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OTRAS
• MTS:Adultos: Riñón- Colon-PulmónNiños: TW- NBT- RTBRealce- Edema
• Lesiones quísticas: - Quiste coloide- Quistes plexos.
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QUISTE COLOIDE• Localización III Ventrículo. TIPICA• < 3 cms. • Elementos
ectópicos del Endodermo
• T1: hiper• T1 + C: No• T2: iso• DWI: No
restringen.
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QUISTES PLEXOSCOROIDEOS
• Quistes Neuro- Epit. +++ BL- Atrio
VL• Tc: iso - No
realce- Ca. periférico
• RM: Variable• T1: Iso-hiper• T1 + C: Periférico• T2: hiper• FLAIR: 2/3 iso.• DWI: 2/3
restringen.
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BIBLIOGRAFÍA• Koeller KK, Sandberg GD. Cerebral intraventricular
neoplasms: radiologic pathologic correlation. RadioGraphics 2002;22(6): 1473-1505.
• SERAM 2014 / S-1158. Lesiones quísticas cerebrales en TC y RM.
• ECR 2013 / C-1554MENINGIOMAS: Imaging findings and interpretative pitfalls.
• ECR 2010/ C-2698 Differential diagnosis of brain ventricular and subependymal lesions.
• ECR 2014/ C-1922 Intraventricular Neoplasms: Radiologic- Pathologic Correlation.
• SERAM 2014/ S-0566 Tumores intraventriculares:nuevas entidades y hallazgos recientes en Resonancia Magnética