頭部MRIで特徴的な液面形成（fluid-fluid level）をみとめた化膿性脳室炎の2例

頭部MRIで特徴的な液面形成（fluid-fluid level）をみとめた化膿性脳室炎の2症例を報告する．両症例とも，側脳室後角に液面形成をともなう，拡散強調像画像高信号，T2強調画像低信号の貯留性病変をみとめた．画像所見より化膿性脳室炎と診断し，高用量メロペネムによる治療を開始した．治療開始後，画像上の異常病変は消失し，臨床症状は完全に寛解した．側脳室における液面形成をともなう貯留性病変は，他疾患では報告がなく化膿性脳室炎に特徴的といえる．化膿性脳室炎は，臨床症状が非特異的であり，診断の遅れから予後が不良になることがあるため，その特徴的な画像所見を認識し，かつ早期から適切な広域スペクトラム...

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Published in臨床神経学 Vol. 54; no. 9; pp. 732 - 737
Main Authors 畠山, 公大, 田邊, 嘉也, 西澤, 正豊, 下畑, 享良, 金澤, 雅人, 石原, 彩子
Format Journal Article
LanguageJapanese
Published 日本神経学会 2014
Subjects
メロペネム
化膿性脳室炎
拡散強調画像
液面形成
Online AccessGet full text
ISSN0009-918X
1882-0654
DOI10.5692/clinicalneurol.54.732

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Abstract 頭部MRIで特徴的な液面形成（fluid-fluid level）をみとめた化膿性脳室炎の2症例を報告する．両症例とも，側脳室後角に液面形成をともなう，拡散強調像画像高信号，T2強調画像低信号の貯留性病変をみとめた．画像所見より化膿性脳室炎と診断し，高用量メロペネムによる治療を開始した．治療開始後，画像上の異常病変は消失し，臨床症状は完全に寛解した．側脳室における液面形成をともなう貯留性病変は，他疾患では報告がなく化膿性脳室炎に特徴的といえる．化膿性脳室炎は，臨床症状が非特異的であり，診断の遅れから予後が不良になることがあるため，その特徴的な画像所見を認識し，かつ早期から適切な広域スペクトラムの抗菌薬を高用量選択することが予後改善に重要である．
AbstractList 頭部MRIで特徴的な液面形成（fluid-fluid level）をみとめた化膿性脳室炎の2症例を報告する．両症例とも，側脳室後角に液面形成をともなう，拡散強調像画像高信号，T2強調画像低信号の貯留性病変をみとめた．画像所見より化膿性脳室炎と診断し，高用量メロペネムによる治療を開始した．治療開始後，画像上の異常病変は消失し，臨床症状は完全に寛解した．側脳室における液面形成をともなう貯留性病変は，他疾患では報告がなく化膿性脳室炎に特徴的といえる．化膿性脳室炎は，臨床症状が非特異的であり，診断の遅れから予後が不良になることがあるため，その特徴的な画像所見を認識し，かつ早期から適切な広域スペクトラムの抗菌薬を高用量選択することが予後改善に重要である．
Author 金澤, 雅人
下畑, 享良
畠山, 公大
石原, 彩子
田邊, 嘉也
西澤, 正豊
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References 16) Palamo F, Madero S, García-Albea E, et al. Carcinomatous ventriculitis. Med Clin 1989;93:679.
3) Bakshi R, Kinkel PR, Mechtler LL, et al. Cerebral ventricular empyema associated with severe adult pyogenic meningitis: computed tomography findings. Clin Neurol Neurosurg 1997;99:252-255.
4) Tsai JC, Dalinka MK, Fallon MD, et al. Fluid-fluid level: a nonspecific finding in tumors of bone and soft tissue. Radiology 1990;175:779-782.
1) Fujikawa A, Tsuchiya K, Honya K, et al. Comparison of MRI sequences to detect ventriculitis. AJR Am J Roentogenol 2006;187:1048-1053.
10) 金澤雅人，西巻啓一，小出隆司ら．MRIでfluid-fluid levelを伴う嚢胞性病変を呈した海面状血管腫の1例．脳と神経 2004;56:695-699.
6) Bayston R, Hart CA, Barnicoat M. Intraventricular vancomycin in the treatment of ventriculitis associated with cerebrospinal fluid shunting and drainage. J Neurol Neurosurg Psychiatry 1987;50:1419-1423.
12) Fukui MB, Williams RL, Mudigonda S. CT and MR imaging features of pyogenic ventriculitis. AJNR Am J Neuroradiol 2001;22:1510-1516.
15) Hong JT, Son BC, Sung JH, et al. Significance of diffusion-weighted imaging and apparent diffusion coefficient maps for the evaluation of pyogenic ventriculitis. Clin Neurol Neurosurg 2008;110:137-144.
22) Ravichandran TP, Fredericks EJ, Goldman RL, et al. Intraventricular B-cell lymphoma from the breast. Neuroradiology 1998;40:522-523.
5) Black PM, Levine BW, Picard EH, et al. Asymmetrical hydrocephalus following ventriculitis from rupture of a thalamic abscess. Surg Neurol 1983;19:524-527.
26) Asano M, Fujimoto N, Fuchimoto Y, et al. Brain abscess mimicking lung cancer metastases; a case report. Clin Imaging 2013;37:147-150.
14) Pezzullo JA, Tung GA, Mudigonda S, et al. Diffusion-weighted MR imaging of pyogenic ventriculitis. AJR Am J Roentogenol 2003;180:71-75.
7) Salmon JH. Ventriculitis complicating meningitis. Am J Dis Child 1972;124:35-40.
11) Breeze RE, McComb JG, Hyman S, et al. CSF production in acute ventriculitis. J Neurosurg 1989;70:619-622.
8) Rahal JJ Jr, Hyams PJ, Simberkoff MS, et al. Combined intrathecal and intramuscular gentamicin for gram-negative meningitis. Pharmacologic study of 21 patients. N Engl J Med 1974;290:1394-1398.
9) 浅利正二，後藤正樹，西本　詮ら．CTでniveauが認められた下垂体卒中の1例．臨放 1988;33:905-906.
25) 細菌性髄膜炎の診療ガイドライン作成委員会．細菌性髄膜炎の診療ガイドライン．神経治療 2007;24:71-132.
27) Theodoridou K, Vasilopoulou VA, Katsiaflaka A, et al. Association of treatment for bacterial meningitis with the development of sequelae. Int J Infect Dis 2013;17:e707-713.
19) Vandesteen L, Drier A, Galanaud D, et al. Imaging findings of intraventricular and ependymal lesions. J Neuroradiol 2013;40:229-244.
24) Lu CH, Chang WN, Chuang YC, et al. The prognostic factors of adult gram-negative bacillary meningitis. J Hosp Infect 1998;40:27-34.
13) Han KT, Choi DS, Ryoo JW, et al. Diffusion-weighted MR imaging of pyogenic intraventricular empyema. Neuroradiology 2007;49:813-818.
18) Salzman KL. Ventriculitis. In: Osborn AG, Salzman KL, Barkovich AJ, editors. Diagnostic imaging. Brain. 2nd ed. Salt Lake City: Amirsys; 2010. p. 32-33.
20) Bakshi R, Kamran S, Kinkel PR, et al. MRI in cerebral intraventricular hemorrhage: analysis of 50 consecutive cases. Neuroradiology 1999;41:401-409.
21) Song WZ, Mao BY, Hu BF, et al. Intraventricular vascular malformations mimicking tumors: case reports and review of the literature. J Neurol Sci 2008;266:63-69.
2) Barloon TJ, Yuh WT, Knepper LE, et al. Cerebral ventriculitis: MR findings. J Comput Assist Tomogr 1990;14:272-275.
17) Kart BH, Reddy SC, Rao GR, et al. Choroid plexus metastasis: CT appearance. J Comput Assist Tomogr 1986;10:537-540.
23) Nakasu Y, Nakasu S, Isozumi T, et al. Periventricular spread of malignant lymphoma: report of two cases. Nihon Geka Hokan 1990;59:323-329.
References_xml – reference: 5) Black PM, Levine BW, Picard EH, et al. Asymmetrical hydrocephalus following ventriculitis from rupture of a thalamic abscess. Surg Neurol 1983;19:524-527.
– reference: 25) 細菌性髄膜炎の診療ガイドライン作成委員会．細菌性髄膜炎の診療ガイドライン．神経治療 2007;24:71-132.
– reference: 10) 金澤雅人，西巻啓一，小出隆司ら．MRIでfluid-fluid levelを伴う嚢胞性病変を呈した海面状血管腫の1例．脳と神経 2004;56:695-699.
– reference: 16) Palamo F, Madero S, García-Albea E, et al. Carcinomatous ventriculitis. Med Clin 1989;93:679.
– reference: 15) Hong JT, Son BC, Sung JH, et al. Significance of diffusion-weighted imaging and apparent diffusion coefficient maps for the evaluation of pyogenic ventriculitis. Clin Neurol Neurosurg 2008;110:137-144.
– reference: 6) Bayston R, Hart CA, Barnicoat M. Intraventricular vancomycin in the treatment of ventriculitis associated with cerebrospinal fluid shunting and drainage. J Neurol Neurosurg Psychiatry 1987;50:1419-1423.
– reference: 8) Rahal JJ Jr, Hyams PJ, Simberkoff MS, et al. Combined intrathecal and intramuscular gentamicin for gram-negative meningitis. Pharmacologic study of 21 patients. N Engl J Med 1974;290:1394-1398.
– reference: 18) Salzman KL. Ventriculitis. In: Osborn AG, Salzman KL, Barkovich AJ, editors. Diagnostic imaging. Brain. 2nd ed. Salt Lake City: Amirsys; 2010. p. 32-33.
– reference: 12) Fukui MB, Williams RL, Mudigonda S. CT and MR imaging features of pyogenic ventriculitis. AJNR Am J Neuroradiol 2001;22:1510-1516.
– reference: 17) Kart BH, Reddy SC, Rao GR, et al. Choroid plexus metastasis: CT appearance. J Comput Assist Tomogr 1986;10:537-540.
– reference: 22) Ravichandran TP, Fredericks EJ, Goldman RL, et al. Intraventricular B-cell lymphoma from the breast. Neuroradiology 1998;40:522-523.
– reference: 11) Breeze RE, McComb JG, Hyman S, et al. CSF production in acute ventriculitis. J Neurosurg 1989;70:619-622.
– reference: 26) Asano M, Fujimoto N, Fuchimoto Y, et al. Brain abscess mimicking lung cancer metastases; a case report. Clin Imaging 2013;37:147-150.
– reference: 24) Lu CH, Chang WN, Chuang YC, et al. The prognostic factors of adult gram-negative bacillary meningitis. J Hosp Infect 1998;40:27-34.
– reference: 19) Vandesteen L, Drier A, Galanaud D, et al. Imaging findings of intraventricular and ependymal lesions. J Neuroradiol 2013;40:229-244.
– reference: 7) Salmon JH. Ventriculitis complicating meningitis. Am J Dis Child 1972;124:35-40.
– reference: 20) Bakshi R, Kamran S, Kinkel PR, et al. MRI in cerebral intraventricular hemorrhage: analysis of 50 consecutive cases. Neuroradiology 1999;41:401-409.
– reference: 14) Pezzullo JA, Tung GA, Mudigonda S, et al. Diffusion-weighted MR imaging of pyogenic ventriculitis. AJR Am J Roentogenol 2003;180:71-75.
– reference: 21) Song WZ, Mao BY, Hu BF, et al. Intraventricular vascular malformations mimicking tumors: case reports and review of the literature. J Neurol Sci 2008;266:63-69.
– reference: 23) Nakasu Y, Nakasu S, Isozumi T, et al. Periventricular spread of malignant lymphoma: report of two cases. Nihon Geka Hokan 1990;59:323-329.
– reference: 4) Tsai JC, Dalinka MK, Fallon MD, et al. Fluid-fluid level: a nonspecific finding in tumors of bone and soft tissue. Radiology 1990;175:779-782.
– reference: 3) Bakshi R, Kinkel PR, Mechtler LL, et al. Cerebral ventricular empyema associated with severe adult pyogenic meningitis: computed tomography findings. Clin Neurol Neurosurg 1997;99:252-255.
– reference: 13) Han KT, Choi DS, Ryoo JW, et al. Diffusion-weighted MR imaging of pyogenic intraventricular empyema. Neuroradiology 2007;49:813-818.
– reference: 1) Fujikawa A, Tsuchiya K, Honya K, et al. Comparison of MRI sequences to detect ventriculitis. AJR Am J Roentogenol 2006;187:1048-1053.
– reference: 27) Theodoridou K, Vasilopoulou VA, Katsiaflaka A, et al. Association of treatment for bacterial meningitis with the development of sequelae. Int J Infect Dis 2013;17:e707-713.
– reference: 2) Barloon TJ, Yuh WT, Knepper LE, et al. Cerebral ventriculitis: MR findings. J Comput Assist Tomogr 1990;14:272-275.
– reference: 9) 浅利正二，後藤正樹，西本　詮ら．CTでniveauが認められた下垂体卒中の1例．臨放 1988;33:905-906.
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SubjectTerms メロペネム
化膿性脳室炎
拡散強調画像
液面形成
Title 頭部MRIで特徴的な液面形成（fluid-fluid level）をみとめた化膿性脳室炎の2例
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