误诊为脑海绵状血管瘤伴出血的颅内占位性病变的影像学特征分析OA

Objective:To explore the clinical and imaging characteristics of intracranial space-occupying lesions misdiag-nosed as cerebral cavernous malformation(CCM)with hemorrhage,to increase the understanding of intracranial CCM-like lesions,and to improve the accuracy of preoperative diagnosis.Methods:The clinical and imaging data of 12 patients with intracranial space-occupying lesions who were misdiagnosed as CCM and confirmed by surgery and pathology in our hospi-tal from January 2013 to March 2024 were retrospectively analyzed,and the relevant literature was reviewed.Results:A total of 12 cases of intracranial space-occupying lesions were misdiagnosed as CCM hemorrhage before surgery,including 7 gliomas,3 metastases,1 epidermoid cyst,and 1 melanoma.All patients presented with varying degrees of neurological symp-toms and underwent MRI examination.Scans and enhanced scans showed that 12 cases were accompanied by hemosiderin rings,11 cases were accompanied by peritumoral edema and mass effect,9 cases had T1WI intratumoral high signal,and 8 cases had cystic areas within the lesions;9 cases of lesions were enhanced.Eight patients underwent brain CT examination,and calcifications were seen in 5 cases.Conclusion:Even if the imaging findings of intracranial space-occupying lesions are extremely supportive of CCM with hemorrhage,we should avoid being satisfied with a single imaging diagnosis,and should also consider brain metastases,gliomas,melanomas and other space-occupying lesions that are prone to bleeding.Especially elderly patients,those with a history of primary tumors,and those whose imaging follow-up shows persistent edema,enhancement,and progression,should actively prompt clinical practice for adequate differential diagnosis.