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一名22岁男子在2个月内出现顽固性进行性头痛。非创伤性头部CT和对比增强MRI扫描显示高密度松果体肿块（图A和图B）。动脉造影正常（图，C和D）。 （a）脑部CT扫描显示松果体区有高密度肿块。（b）T1加权后对比度MRI显示对比度增强最小。数字减影血管造影显示肿块区无动脉（C）或静脉（D）异常，提示Galen动脉瘤的血栓形成静脉。 术中观察到明显静脉引流的肿块。组织学证实了Galen相关血栓动脉瘤静脉的诊断。 加伦静脉相关动脉瘤在成人中很少见。 1常在儿童期出现高输出量心力衰竭。 2它们表现为等密度到高密度的松果体肿块，在钛加权磁共振成像上具有最小的异质性增强，从而模拟松果体肿瘤的放射学和临床特征，如我们的病例。 英文原文： Veinof Galen aneurysm mimicking pineal mass in a young adult A 22-year-old man presented with intractableprogressive headaches over 2 months. Noncontrast head CT and contrast-enhancedMRI scan revealed a hyperdense pineal-based mass (figure, A and B). Arteriogramwas normal (figure, C and D). (A)CT scan of brain shows hyperdense mass in pineal region. (B) T1-weightedpostcontrast MRI shows minimal contrast enhancement. Digital subtractionangiogram demonstrates no arterial (C) or venous (D) abnormalities in theregion of mass, implying thrombosed vein of Galen aneurysm. Intraoperatively, a firm mass wasobserved with apparent venous drainage. Histology confirmed thediagnosis of vein of Galen–related thrombosed aneurysm. Vein of Galen–related aneurysms arerare in adults. 1. They oftenpresent in childhood with high-output cardiac failure. 2. Theypresent as isodense to hyperdense pineal mass with minimalheterogeneous contrast enhancement on TI-weighted MRI,thus mimicking radiologic and clinical features of pineal tumors, as in ourcase. |
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