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Neuroradiologie Scan 2012; 02(04): 255-274
DOI: 10.1055/s-0032-1310080
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© Georg Thieme Verlag KG Stuttgart · New York

Raumforderungen und Fehlbildungen des III. Ventrikels: anatomische Normalverhältnisse und Differenzialdiagnose[1]

Masses and malformations of the third ventricle: normal anatomic relationships and differential diagnoses
Christine M. Glastonbury
,
Anne G. Osborn
,
Karen L. Salzman
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Publication History

Publication Date:
01 October 2012 (online)

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Zusammenfassung

Der III. Ventrikel liegt im Zentrum des Gehirns. Er ist von empfindlichen Kernstrukturen (Hypothalamus und Thalami) sowie wichtigen Drüsen (Hypophyse und Zirbeldrüse) umgeben. Es gibt viele verschiedene pathologische Prozesse, die den III. Ventrikel involvieren können, wobei extrinsische Raumforderungen am häufigsten sind. Mit entsprechenden Kenntnissen der anatomischen Grenzen des III. Ventrikels und seiner Beziehung zu angrenzenden Strukturen lassen sich relevante Differenzialdiagnosen erstellen. Raumforderungen des III. Ventrikels werden anhand ihres Ursprungs oder ihrer Lage in 5 Kategorien unterteilt: anterior, posterior, inferior, am Foramen interventriculare und intraventrikulär. Anteriore Raumforderungen involvieren den Recessus supraopticus und den Recessus infundibularis, posteriore Raumforderungen wachsen in der oder betreffen die Commissura posterior und die Zirbeldrüse. Inferiore Raumforderungen involvieren oder betreffen den Ventrikelboden. Raumforderungen können auch am oder nahe dem Foramen interventriculare entspringen oder als intraventrikuläre Raumforderung gänzlich im III. Ventrikel liegen. Das Chordoidgliom, eine seltene, niedriggradige Primärneoplasie, gehört zu den intraventrikulären Raumforderungen und kommt nur im III. Ventrikel vor. Angeborene Fehlbildungen des III. Ventrikels sind selten und werden meistens während der Kindheit entdeckt. Die meisten dieser Anomalien sind Malformationen der Neurohypophyse, die sich als Hormonstörungen manifestieren, oder Stenosen des Aquädukts, die zu einer Erweiterung des III. Ventrikels und der Seitenventrikel (Hydrozephalus) führen.

Abstract

The third ventricle lies in the center of the brain. It is surrounded by critical nuclear structures (the hypothalamus and thalami) and important glandular structures (the pituitary and pineal glands). Although a wide array of pathologic processes may involve the third ventricle, most are extrinsic masses. By understanding the anatomic boundaries of the third ventricle and its relationship to adjacent structures, it is possible to create short lists of differential diagnoses. Third ventricle masses can be classified as arising in or immediately adjacent to one of five locations: anterior, posterior, inferior, foramen of Monro, and intraventricular. Anterior masses involve the optic and infundibular recesses, posterior masses affect or arise in the posterior commissure and pineal gland, and inferior masses involve or affect the ventricle floor. Masses may also arise at or adjacent to the foramen of Monro or entirely within the third ventricle. Of the intraventricular masses, chordoid glioma – a rare low-grade primary neoplasm – is unique to the third ventricle. Congenital malformations of the third ventricle are uncommon and are most often noted during childhood. Most commonly, these anomalies represent malformations of the neurohypophysis, which may manifest as hormonal abnormalities, or stenosis of the aqueduct of Sylvius, which manifests as dilatation of the third and lateral ventricles (hydrocephalus).

1 © 2011 The Radiological Society of North America. All rights reserved. Originally puplished in English in RadioGraphics 2011; 31: 1889 – 1905. Online published in 10.1148 /rg.317115083. Translated and reprinted with permission of RSNA. RSNA is not responsible for any inaccuracy or error arising from the translation from English to German.


 

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