Abstract：
BACKGROUND: The movement of intraventricular silicone oil observed in the supine position is extremely rare. Herein, we describe a patient who presented with dynamically moving silicone oil particles in the ventricle when changing position and provide an updated review of this phenomenon.
METHODS: We report a case of a 70-year-old woman who presented with intraventricular hyperdensities that were occasionally found on brain computed tomography (CT). Initial nonenhanced brain CT demonstrated nondependent hyperdensities in the bilateral anterior horns of the lateral ventricles, the third ventricle, and the right suprasellar cistern, mimicking an intraventricular hemorrhage. Further brain magnetic resonance imaging (MRI) in the supine position revealed abnormal signals in the bilateral anterior horns of the lateral ventricles, the posterior horn of the right lateral ventricle, the third ventricle, the right suprasellar cistern, and the bilateral eyeballs, with isosignal intensities surrounded by low-signal chemical shift artifacts on T1-weighted imaging and variable signals (hypo- or hyperintensity) on T2-weighted imaging. The lesion in the anterior horn of the right ventricle largely moved to the posterior horn of the ipsilateral ventricle. The final craniocervical CT angiography showed that the lesion in the posterior horn had moved back to the anterior horn of the right lateral ventricle. These features were consistent with intraventricular silicone oil migration. The final spinal MRI did not demonstrate a migration of silicone oil into the spinal subarachnoid space.
CONCLUSIONS: This case report describes a dynamic process of silicone oil displacement in the supine position and provides a comprehensive imaging presentation. The moving pattern and a characteristic chemical shift artifact on MRI are key to the diagnosis and may help prevent unnecessary examinations or intervention.
METHODS: We report a case of a 70-year-old woman who presented with intraventricular hyperdensities that were occasionally found on brain computed tomography (CT). Initial nonenhanced brain CT demonstrated nondependent hyperdensities in the bilateral anterior horns of the lateral ventricles, the third ventricle, and the right suprasellar cistern, mimicking an intraventricular hemorrhage. Further brain magnetic resonance imaging (MRI) in the supine position revealed abnormal signals in the bilateral anterior horns of the lateral ventricles, the posterior horn of the right lateral ventricle, the third ventricle, the right suprasellar cistern, and the bilateral eyeballs, with isosignal intensities surrounded by low-signal chemical shift artifacts on T1-weighted imaging and variable signals (hypo- or hyperintensity) on T2-weighted imaging. The lesion in the anterior horn of the right ventricle largely moved to the posterior horn of the ipsilateral ventricle. The final craniocervical CT angiography showed that the lesion in the posterior horn had moved back to the anterior horn of the right lateral ventricle. These features were consistent with intraventricular silicone oil migration. The final spinal MRI did not demonstrate a migration of silicone oil into the spinal subarachnoid space.
CONCLUSIONS: This case report describes a dynamic process of silicone oil displacement in the supine position and provides a comprehensive imaging presentation. The moving pattern and a characteristic chemical shift artifact on MRI are key to the diagnosis and may help prevent unnecessary examinations or intervention.
摘要：
背景：仰卧位观察到的脑室内硅油的运动极为罕见。在这里，我们描述了一名患者在改变位置时出现心室中动态移动的硅油颗粒，并提供了对这一现象的最新综述。
方法：我们报告了一例70岁的女性，其表现为脑计算机断层扫描（CT）偶尔发现的脑室内高密度。最初的非增强脑CT显示侧脑室双侧前角的非依赖性高密度，第三脑室,和右侧的鞍上水箱，模仿脑室内出血.仰卧位进一步脑部磁共振成像（MRI）显示侧脑室双侧前角异常信号，右心室的后角,第三脑室,右边的上层水箱,和双侧眼球，等信号强度在T1加权成像上被低信号化学位移伪影包围，在T2加权成像上被可变信号（低强度或高强度）包围。右心室前角的病变大部分移至同侧心室的后角。最终的颅颈CT血管造影显示，后角的病变已移回右心室的前角。这些特征与脑室内硅油迁移一致。最终的脊柱MRI未显示硅油迁移到脊髓蛛网膜下腔。
结论：该病例报告描述了仰卧位硅油驱替的动态过程，并提供了全面的影像学表现。MRI上的运动模式和特征性化学位移伪影是诊断的关键，可能有助于防止不必要的检查或干预。
方法：我们报告了一例70岁的女性，其表现为脑计算机断层扫描（CT）偶尔发现的脑室内高密度。最初的非增强脑CT显示侧脑室双侧前角的非依赖性高密度，第三脑室,和右侧的鞍上水箱，模仿脑室内出血.仰卧位进一步脑部磁共振成像（MRI）显示侧脑室双侧前角异常信号，右心室的后角,第三脑室,右边的上层水箱,和双侧眼球，等信号强度在T1加权成像上被低信号化学位移伪影包围，在T2加权成像上被可变信号（低强度或高强度）包围。右心室前角的病变大部分移至同侧心室的后角。最终的颅颈CT血管造影显示，后角的病变已移回右心室的前角。这些特征与脑室内硅油迁移一致。最终的脊柱MRI未显示硅油迁移到脊髓蛛网膜下腔。
结论：该病例报告描述了仰卧位硅油驱替的动态过程，并提供了全面的影像学表现。MRI上的运动模式和特征性化学位移伪影是诊断的关键，可能有助于防止不必要的检查或干预。
