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The bright choroid plexus on MR: CT and pathologic correlation
D B Hinshaw1, J L Fahmy, N Peckham
1Section of Magnetic Resonance Sciences, Loma Linda University, CA 92354.
Abstract:
Fourteen patients studied with MR imaging were found, incidentally, to have unusually bright, large choroid plexus glomera on T2-weighted sequences. A group of 167 patients was then examined retrospectively for size and intensity of the choroid plexus glomera on T2-weighted images. In the latter group of 167 patients, 66 (39.5%) had bright choroid plexus glomera. Of those who had bright choroid plexus glomera, eight of the 14 initial group and 11 of the 66 patients studied retrospectively had previous CT scans. The typical CT appearance of these bright glomera consisted of nonenhancing central regions of low (but not negative) attenuation with peripheral calcifications in the majority. The remainder showed noncalcified glomera. Fifty-two glomera were obtained at autopsy and examined retrospectively. Eight showed small, variably sized masses with lipid deposits, neuroepithelial microcysts, and peripheral psammoma body calcifications. One patient who died had a bright choroid plexus glomus on MR, and his glomera showed the same pathologic findings. The autopsy findings were believed to be typical pathologically for early xanthogranulomata formation. These early xanthogranulomatous changes appear to be of little clinical significance but must be differentiated from other lesions that can produce bright or enlarged choroid plexus glomera on MR.
Insights
Bright choroid plexus glomera on MRI may indicate early xanthogranulomata. These findings are typically benign but require differentiation from other potential lesions.
Area of Science:
- Neuroradiology
- Pathology
Background:
- Choroid plexus glomera can appear unusually bright and enlarged on T2-weighted MRI sequences.
- Incidental findings prompt further investigation into their nature and significance.
Purpose of the Study:
- To investigate the characteristics and pathological basis of bright choroid plexus glomera identified on MRI.
- To determine the clinical significance and differential diagnoses of these findings.
Main Methods:
- Retrospective review of MR imaging in 14 patients with incidental findings and 167 additional patients.
- Analysis of CT scans for correlation with MR findings.
- Autopsy examination of 52 choroid plexus glomera for pathological correlation.
Main Results:
- 39.5% of 167 patients exhibited bright choroid plexus glomera on T2-weighted MRI.
- CT scans revealed nonenhancing central regions with peripheral calcifications in most bright glomera.
- Autopsy findings in eight glomera showed lipid deposits, microcysts, and calcifications consistent with early xanthogranulomata.
Conclusions:
- Bright and enlarged choroid plexus glomera on MRI are often associated with early xanthogranulomatous changes.
- These pathological changes are generally of low clinical significance.
- It is crucial to differentiate these findings from other lesions that may mimic bright or enlarged choroid plexus glomera on MRI.