内視鏡下第三脳室開窓術後に発生したゼラチンスポンジ肉芽腫の画像所見

Diagnostic imaging of gelatin sponge granuloma：a case report and review of literature

ゼラチンスポンジは外科手術で頻用される被吸収性止血剤の1つである。止血や髄液漏出の予防のために広く使用されており，神経内視鏡手術においても抜去時に手術経路に留置する場合がある^1）2）。頭蓋内のゼラチンスポンジ肉芽腫は非常にまれな合併症であり^3），その画像的特徴についてはあまり知られていない。

This case involved a 7-year-old girl who presented with fever and seizures 27 days after undergoing endoscopic third ventriculostomy for hydrocephalus. A mass in the postoperative area was identified on MR imaging, subsequently resected, and diagnosed as a gelatin sponge granuloma. Gelatin sponge granuloma is a very rare complication and it is often misdiagnosed as an abscess or a tumor recurrence, making imaging diagnosis crucial. Reviewing images from this case and previous reports suggests that the presence of high ADC values, punctate circular low signal intensity on constructive interference in steady state（CISS）, and blooming on T2^＊ weighted imaging may be useful for diagnosing gelatin sponge granuloma.