Abstract
Amaç: Bu çalışmanın amacı halka şekilli lateral ventrikül nodüllerinin (RSLVN) konvansiyonel ve difüzyon MR bulgularını klinik özellikleriyle birlikte değerlendirmektir.
Gereç ve Yöntem: 2019-2023 yılları arasında kontrastlı beyin MR çekimi bulunan tüm hastaların MR görüntüleri retrospektif olarak değerlendirildi. T1 ağırlıklı (T1W), T2 ağırlıklı (T2W), FLAIR ve difüzyon ağırlıklı görüntülemede (DAG) RSLVN'lerin sayısı, şekli, maksimum çapı ve sinyal yoğunluğu ve kontrast tutulum durumu değerlendirildi. Nodüllerin görünür difüzyon katsayısı (ADC) değerleri ve normalleştirilmiş ADC oranları da belirlendi. Takip MR'ları yapıldıysa, RSLVN'lerin zaman içerisindeki morfolojik değişiklikleri değerlendirildi.
Bulgular: Çalışmaya dahil edilen 2920 hastanın 15'inde (%0,51) RSLVN saptandı. Beş hastada birden fazla RSLVN gözlendi ve dolayısıyla on beş hastada toplam 23 RSLVN tanımlandı. Nodüllerin sekizi (%34,8) lateral ventrikül tavanında, on iki tanesi (%52,2) ön boynuzda, üçü ise septum pellucidum'da yerleşmişti. 23 RSLVN'den 6'sı (%26,1) 1 cm'den büyüktü. Tüm RSLVN'ler T1W ve T2W'de izointens, FLAIR sekansında ise hiperintensti. DAG'de 23 RSLVN'den 20'sinde izointens sinyal vardı, geri kalan 3 lezyon ise hiperintens idi. Ortalama ADC değeri ve nADC oranı sırasıyla 1,42 ± 0,29 x 10-3mm2 ve 1,87 ± 0,31 idi.
Sonuç: RSLVN sıklığı daha önce bildirilenden daha sık olabilir. Konvansiyonel MR görünümleri ve tipik lokalizasyonları ayırt edicidir ve nispeten büyük boyutlara ulaşabilirler. Takip sırasındaki morfolojik stabilite ve bu lezyonların ADC değerleri olası benign bir doğaya işaret etmektedir.
Project Number
831892
References
- 1. Shimono T, Hosono M, Ashikaga R, Kumano S, Imaoka I, Yagyu Y, et al. Ring-shaped lateral ventricular nodules: an incidental finding on brain magnetic resonance imaging. Neuroradiology. 2009;51(3):145-50.
- 2. Nakajima R, Uchino A, Saito N, Nishikawa R. Ring-shaped Lateral Ventricular Nodules Detected with Brain MR Imaging. Magn Reson Med Sci. 2013;12 (2):105-10.
- 3. Pontillo G, Lepore G, Bartolini A, Cerase A, Brunetti A, Muccio CF. Is This Truly A “Leave-Me-Alone” Lesion? An Unusual Case of Multiple Ring-shaped Lateral Ventricular Nodules. World Neurosurg. 2020;136:32-6.
- 4. Kuya K, Shinohara Y, Yoshioka H, Kuwamoto S, Kurosaki M, Ogawa T. A Case of Intracranial Subependymoma: Histopathological Confirmation of Ring-shaped Lateral Ventricular Nodule. Magn Reson Med Sci. 2018;17(2):105-6.
- 5. Romano N, Fiannacca M, Castaldi A. Imaging of ring-shaped lateral ventricular nodules (RSLVNs). Neurol Sci. 2023;44(6):2223-5.
- 6. Rosa Júnior M, Vieira VLF. Ring-shaped lateral ventricular nodules: a “leave me alone” lesion. Arq Neuropsiquiatr. 2018;76 (7):494.
- 7. Kono K, Inoue Y, Nakayama K, Shakudo M, Morino M, Ohata K, et al. The Role of Diffusion-weighted Imaging in Patients with Brain Tumors. Am J Neuroradiol. 2001;22 (6):1081-8.
- 8. Wang Q, Zhang J, Xu X, Chen X, Xu B. Diagnostic performance of apparent diffusion coefficient parameters for glioma grading. J Neurooncol. 2018;139(1):61-8.
- 9. Nagar VA, Ye JR, Ng WH, Chan YH, Hui F, Lee CK, et al. Diffusion-Weighted MR Imaging: Diagnosing Atypical or Malignant Meningiomas and Detecting Tumor Dedifferentiation. Am J Neuroradiol. 2008;29(6):1147-52.
- 10. Hoeffel C, Boukobza M, Polivka M, Lot, G, Guichard, JP, Lafitte F, et al. MR manifestations of subependymomas. AJNR Am J Neuroradiol. 1995;16(10):2121-9.
- 11. Bi Z, Ren X, Zhang J, Jia W. Clinical, radiological, and pathological features in 43 cases of intracranial subependymoma. J Neurosurg. 2015;122(1):49-60.
- 12. Nishio S, Morioka T, Mihara F, Fukui M. Subependymoma of the lateral ventricles. Neurosurg Rev. 2000;23(2):98-103.
Abstract
Objective: The aim of this study is to evaluate the conventional and diffusion MRI findings of ring-shaped lateral ventricular nodules (RSLVN) along with clinical features.
Methods: MR images of all patients who underwent contrast-enhanced brain MRI between 2019 and 2023 were retrospectively evaluated. The number, shape, maximal diameter, and signal intensity of RSLVNs on T1-weighted (T1W), T2-weighted (T2W), fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI), and contrast-enhancement status were evaluated. Apparent diffusion coefficient (ADC) values and normalized ADC ratios of nodules were also determined. If follow-up MRIs were performed, morphological changes of RSLVNs were evaluated.
Results: RSLVN was observed in fifteen (0.51%) of 2920 patients. Multiple RSLVNs were observed in five patients and therefore a total of 23 RSLVNs were identified in fifteen patients. Nodules were located on the roof of the lateral ventricle in eight nodules (34.8%), in the frontal horn in twelve nodules (52.2%), and in the septum pellucidum in three. 6 of 23 RSLVNs (26.1%) were larger than 1 cm. All RSLVNs were isointense on T1W and T2W, while hyperintense on FLAIR. On DWI, 20 of 23 RSLVNs had isointense signal and the remaining 3 lesions were hyperintense. The mean ADC value and nADC ratio were 1.42 ± 0.29 x 10-3mm2 and 1.87 ± 0.31, respectively.
Conclusion: RSLVNs may be more frequent than previously reported. Their uniform MRI appearance and typical localizations are distinctive, and they can reach relatively large sizes. Morphological stability during follow-up and the ADC values of these lesions suggest a possible benign nature.
Ethical Statement
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Istanbul University-Cerrahpasa (Decision number: 831892).
Supporting Institution
None.
Project Number
831892
References
- 1. Shimono T, Hosono M, Ashikaga R, Kumano S, Imaoka I, Yagyu Y, et al. Ring-shaped lateral ventricular nodules: an incidental finding on brain magnetic resonance imaging. Neuroradiology. 2009;51(3):145-50.
- 2. Nakajima R, Uchino A, Saito N, Nishikawa R. Ring-shaped Lateral Ventricular Nodules Detected with Brain MR Imaging. Magn Reson Med Sci. 2013;12 (2):105-10.
- 3. Pontillo G, Lepore G, Bartolini A, Cerase A, Brunetti A, Muccio CF. Is This Truly A “Leave-Me-Alone” Lesion? An Unusual Case of Multiple Ring-shaped Lateral Ventricular Nodules. World Neurosurg. 2020;136:32-6.
- 4. Kuya K, Shinohara Y, Yoshioka H, Kuwamoto S, Kurosaki M, Ogawa T. A Case of Intracranial Subependymoma: Histopathological Confirmation of Ring-shaped Lateral Ventricular Nodule. Magn Reson Med Sci. 2018;17(2):105-6.
- 5. Romano N, Fiannacca M, Castaldi A. Imaging of ring-shaped lateral ventricular nodules (RSLVNs). Neurol Sci. 2023;44(6):2223-5.
- 6. Rosa Júnior M, Vieira VLF. Ring-shaped lateral ventricular nodules: a “leave me alone” lesion. Arq Neuropsiquiatr. 2018;76 (7):494.
- 7. Kono K, Inoue Y, Nakayama K, Shakudo M, Morino M, Ohata K, et al. The Role of Diffusion-weighted Imaging in Patients with Brain Tumors. Am J Neuroradiol. 2001;22 (6):1081-8.
- 8. Wang Q, Zhang J, Xu X, Chen X, Xu B. Diagnostic performance of apparent diffusion coefficient parameters for glioma grading. J Neurooncol. 2018;139(1):61-8.
- 9. Nagar VA, Ye JR, Ng WH, Chan YH, Hui F, Lee CK, et al. Diffusion-Weighted MR Imaging: Diagnosing Atypical or Malignant Meningiomas and Detecting Tumor Dedifferentiation. Am J Neuroradiol. 2008;29(6):1147-52.
- 10. Hoeffel C, Boukobza M, Polivka M, Lot, G, Guichard, JP, Lafitte F, et al. MR manifestations of subependymomas. AJNR Am J Neuroradiol. 1995;16(10):2121-9.
- 11. Bi Z, Ren X, Zhang J, Jia W. Clinical, radiological, and pathological features in 43 cases of intracranial subependymoma. J Neurosurg. 2015;122(1):49-60.
- 12. Nishio S, Morioka T, Mihara F, Fukui M. Subependymoma of the lateral ventricles. Neurosurg Rev. 2000;23(2):98-103.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Services and Systems (Other) |
| Journal Section | Articles |
| Authors | |
| Project Number | 831892 |
| Publication Date | March 14, 2024 |
| Submission Date | December 23, 2023 |
| Acceptance Date | February 14, 2024 |
| Published in Issue | Year 2024 |