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Radiology
Choroid Plexus Anomalies Cysts and Papillomas
Built from Obstetric Imaging
What’s inside
9 sections · 88 slides
Overview
- Two very different findings, one small structure
- How this topic is built
The normal choroid plexus
What it is, what it makes, and how it forms
- What the choroid plexus actually is
- Where the choroid plexus sits in the brain
- The plexus is an infolding of the pia mater
- Why this one tissue matters so much
- How cerebrospinal fluid circulates
- The border guard: the blood-CSF-brain barrier
- When and where the plexus appears
- The order the plexus appears in
- From a bulge to a working fluid factory
- What a normal plexus looks like on a scan
Choroid plexus cysts
Common, transient, and almost always harmless
- What a choroid plexus cyst is
- 0.18-3.6%
- How often they turn up
- How a cyst gets made
- From growth spurt to visible cyst
- Why the cysts vanish again
- A cyst wall is built differently from normal plexus
- Cysts in both lateral ventricles at 20 weeks
- Calipers across a cyst in the left lateral ventricle
- Coronal tomographic slices through both cysts
- What to look at in those images
- The ultrasound signature of a cyst
- The look of the cyst carries no message
Cysts and chromosomes
The trisomy 18 question, answered with numbers
- Why anyone worries about a harmless pocket
- How strong is the signal, in numbers
- In trisomy 18, cysts rarely travel alone
- A cyst that did signal a chromosome problem
- Reading the risk table that follows
- Approximate Risk of Trisomy 18 in Fetuses With Choroid Plexus Cysts
- Same cyst, very different meaning
- Other things that move the starting risk
- Looking deeper than a karyotype
- What the array cohort actually found
- Cysts are not a marker for Down syndrome
- What happens to these children later
- Even when a big cyst widens the ventricle
Choroid plexus papilloma
A rare tumour that makes too much fluid
- What a papilloma is
- How the World Health Organization grades these tumours
- The three grades of choroid plexus tumour
- How rare is rare
- Where in the brain it grows
- 70-80%
- The genetics behind the tumour
- Papillomas and chromosome syndromes
- What it looks like under the microscope
- Papillary fronds lined by a single layer of cells
- A papilloma filling the ventricle
- Why the tumour floods the brain with fluid
- From tumour to hydrocephalus
- Malignant change and long-term survival
- How it shows itself before birth
- How it shows itself after birth
- A growing intraventricular tumour over two weeks
- Power Doppler showing the tumour's feeding vessel
- The ultrasound signature of a papilloma
Imaging findings side by side
Ultrasound and magnetic resonance imaging
- Two lesions, two ultrasound signatures
- Ultrasound Findings in Cysts and Papillomas
- Cysts on magnetic resonance imaging
- Papillomas on magnetic resonance imaging
What else could it be?
Mimics of the cyst and mimics of the mass
- Other cystic lesions inside the fetal brain
- How the mimics differ from each other
- Distinguishing Features of Lateral Intracranial Cysts
- Other intracranial masses in the fetus
- Doppler settles the clot question
Management and counselling
When to test, when to operate, what to say
- The unsettled question about cysts
- Step one: scan the whole fetus
- Step two: start from the prior risk
- Step three: when to offer karyotyping
- The decision that follows a cyst
- After the baby is born: isolated cysts
- Managing a papilloma before delivery
- Treating a papilloma after delivery
- Reducing the risk, and what to avoid
What to tell the referring doctor
Counselling scripts and the points to remember
- The counselling script for a cyst
- The counselling script for a papilloma
- Key points on cysts, part one
- Key points on cysts, part two
- Key points on papillomas
- Cyst versus papilloma, in one view
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition