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Brain and Nerve No to Shinkei Volume 55, Issue 6 （June 2003）

Brain and Nerve 脳と神経 55巻6号（2003年6月発行）

Japanese English

症例報告

造影後FLAIR画像による脳静脈性血管腫の診断―2症例の報告― Contrast Enhanced Fast Fluid-Attenuated Inversion-recovery MR Imaging for Diagnosing Cerebral Venous Angioma : Report of Two Cases 山崎文之 ¹ , 栗栖薫 ¹ , 有田和徳 ¹ , 山中正美 ² , 大庭信二 ¹ , 花谷亮典 ¹ , 渋川正顕 ¹ , 岐浦禎展 ¹ , 坂本繁幸 ¹ , 岡崎貴仁 ¹ , 高羽順子 ³ , 安部伸和 ³ Fumiyuki Yamasaki ¹ , Kaoru Kurisu ¹ , Kazunori Arita ¹ , Masami Yamanaka ² , Shinji Ohba ¹ , Ryosuke Hanaya ¹ , Masaaki Shibukawa ¹ , Yoshihiro Kiura ¹ , Shigeyuki Sakamoto ¹ , Takahito Okazaki ¹ , Junko Takaba ³ , Nobukazu Abe ³ ¹広島大学脳神経外科 ²太田川病院脳神経外科 ³広島大学放射線科 ¹Department of Neurosurgery, Graduate School of Biomedical Sciences, Hiroshima University ²Department of Neurosurgery, Ohtagawa Hospital ³Department of Radiology, Graduate School of Biomedical Sciences, Hiroshima University キーワード： contrast-enhanced FLAIR imaging , cerebral venous angioma , magnetic resonance imaging Keyword: contrast-enhanced FLAIR imaging , cerebral venous angioma , magnetic resonance imaging pp.537-541

発行日 2003年6月1日 Published Date 2003/6/1

DOI https://doi.org/10.11477/mf.1406100503

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Abstract 文献概要
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要旨　造影後fluid-attenuated inversion-recovery（FLAIR）画像は，腫瘍の髄腔内播種と皮質下静脈の鑑別に有用であることが知られている。今回，造影後FLAIR画像が脳静脈性血管腫と腫瘍性疾患の鑑別に有用であった2例を報告した。症例1は皮質下出血にて発症した71歳男性で，出血原因の精査で造影MRIを施行した。造影後T1強調画像では増強されるが，造影後FLAIR画像では増強されない病変が血腫周囲に描出され，脳静脈性血管腫と診断した。症例2は，脳実質にT2強調画像で高信号を示す病変の内部に，造影後T1強調画像では増強されるが，造影後FLAIR画像では増強されない病変が描出され脳静脈性血管腫と診断した。脳静脈性血管腫は造影後T1強調画像では増強されるが，造影後FLAIR画像では増強されなかった。造影病変としての脳静脈性血管腫を腫瘍性疾患と鑑別するのに，造影後FLAIR画像は有用であった。

It has been reported that contrast-enhanced fluid-attenuated inversion-recovery （FLAIR） sequences were useful for detecting superficial abnormalities, such as meningeal disease, because they do not demonstrate contrast enhancement of cortical vessels with slow flow as do T1-weightedimages. We reported the usefulness of contrast-enhanced FLAIR images to differentiate cerebral venous angioma from tumor in two patients.

Case 1 was a 71-year-old man developed cortical hemorrhage. Post contrast-enhanced T1-weighted images showed an enhanced lesion around the hematoma, whereas contrast-enhanced FLAIR images showed no enhancement of the lesion, thus he was diagnosed as cortical hemorrhage from cerebral venous angioma.

Case 2 was a 72-year-old woman, who was examined MR images because of the jugular foramen neurinoma. There was a T2-high-intensity lesion in the right frontal lobe, and post contrast-enhanced T1-weighted images showed an enhanced lesion in and around the T2-high-intensity lesion. Post-contrast FLAIR images showed no enhancement, and she was diagnosed as cerebral venous angioma.

Contrast-enhanced fast FLAIR sequences was useful in differentiation between venous angiomas and tumors. Identification of these lesions was due to the flow-void phenomenon in vessels with slow-flowing blood such as venous angioma, which could not be differentiated from tumors on T1-weighted images.