Learning objectives
To provide a systematic approach to imaging diagnosis of intraventricular/subependymal lesions by:Identifying site of originDefining lesions extentAssessing growth patternCorrelating imaging and clinical dataTo propose diagnostic hypotheses and to underline the differential diagnosis issues , facing with heterogeneous and challenging imaging pictures.
Background
A lesion may be considered intraventricular if it is found primarily within the ventricular system, causing expansion of the ventricle; therefore, it may be sometimes difficult to establish the exact origin of a lesion, for example to assess if a mass extends from the ventricular wall to the ventricular cavity or vice-versa. Nevertheless, we may classify ventricular lesions in two main categories: those that originate from the ventricular walls (i.e. from the subependymal / subventricular region) and subsequently grow into the ventricle, and those that...
Imaging findings OR Procedure details
1 – Lesion DetectionAlthough such lesions are relatively easy to recognize because of the great contrast between these soft tissue masses and the surrounding CSF, they may present many overlapping imaging features. (Fig 1)2 – Site of Origin vs. Patients’ ageOnce a lesion has been discovered , the next thing to do is the anatomical localization.First, locate the lesion in the supratentorial or infratentorial compartment and try to establish if it’s a true intraventricular or a subependymal one; then, among the most common lesions occurring...
Conclusion
The diagnosis of ventricular and subependymal lesions is possible starting with the precise definition of the origin, then estimating patterns of growth and direction, and finally integrating all suitable tissue characterization diagnostic tools with clinical data.
Personal Information
Affiliations:Institute of RadiologyDept. of Bio-imaging and Radiological SciencesCatholic University and School of MedicineRome - ITALY*A special thank to dr. Emanuele Pravatà for his precious contribution.
References
Goergen SK, Gonzales MF, McLean CA. Interventricular neurocytoma: radiologic features and review of the literature. Radiology. 1992 Mar;182(3):787-92. Review.Greenberg MD. Intraventricular lesions. In: Handbook of neurosurgery. 3rd edition. Lakeland: Greenberg Graphics Inc.; 1994. p 203–205.Guermazi A, De Kerviler E, Zagdanski AM, Frija J. Diagnostic imaging of choroid plexus disease. Clin Radiol. 2000 Jul;55(7):503-16. Review.Horská A, Ulug AM, Melhem ER, Filippi CG, Burger PC, Edgar MA, Souweidane MM, Carson BS, Barker PB. Proton magnetic resonance spectroscopy of choroid plexus tumors in children. J Magn Reson Imaging....