History:A30-year-oldwomanpresentswithvertigo.
病史：30岁女性，眩晕。
Acontrast-enhancedMRIscanofthebrainwasperformed.AxialT2-weighted,T2-weightedfluid-attenuatedinversion-recovery(FLAIR),andT1-weightedandT1-weightedpostcontrastMRimagesareshownbelow.颅脑MR增强扫描：轴位T2WI、T2-FLAIR、T1WI及T1WI增强图像如下所示。
Findings
MRIdemonstratesaclusterofwell-delineated,variable-sizedFLAIR/T2-hyperintensecystswithintheleftfrontalsubcorticalwhitematter,withoutobviousmasseffectorpostcontrastenhancement.
影像表现：
MRI示左侧额叶皮层下白质内有一簇边界清晰的大小不等的FLAIR/T2高信号的囊肿，无明显占位效应或强化。
Differentialdiagnosis
Multinodularandvacuolatingneuronaltumor
Dysembryoplasticneuroepithelialtumor
Focalcorticaldysplasia
Tumefactiveperivascularspaces
Pilocyticastrocytoma
Ganglioglioma
Pleomorphicxanthoastrocytoma
鉴别诊断：
大脑多结节及空泡性神经元肿瘤
胚胎发育不良性神经上皮肿瘤（DNET）
局灶性皮质发育不良
瘤样血管周围间隙
毛细胞型星形细胞瘤
节细胞胶质瘤
多形性*色星形细胞瘤
Diagnosis:Multinodularandvacuolatingneuronaltumor(MVNT)
最后诊断：大脑多结节及空泡性神经元肿瘤(MVNT)
MVNT
Pathophysiology,epidemiology,andclinicalpresentation：
MultinodularandvacuolatingneuronaltumorsareamorerecentlycharacterizedWorldHealthOrganization(WHO)grade1centralnervoussystemneoplasm.Thisrareentityhasonlybeendescribedinseveralcaseseries.Theyarecharacterizedasabenign,mixedglialneuronallesionconsistingofnodulesofdisorganizedneuronalcellslocatednearthesubcorticalwhitematter.Theyareassociatedwithlong-termseizuresinadultsinabout30%ofpatients,buttheyaremostoftenfoundincidentallyandareconsidered"donottouch"or"leavemealone"lesionsifnotassociatedwithintractableepilepsy.
病理生理学，流行病学和临床表现：
多结节和空泡性神经元肿瘤是最近出现在中枢神经系统肿瘤WHO1级中的，这种罕见的病变仅在几个案例系列中被描述。
主要特征是良性的混合性的胶质神经元病变，位于皮层下白质附近，由紊乱的神经元细胞结节组成。
与大约30％的成年人的长期癫痫发作有关，通常为偶然发现，如果与难治性癫痫无关，无需处理。
Imagingfeatures
TheyaredifficulttoidentifyonCTbutmayexhibithypoattenuation.
OnMRI,theyareseenasasubcorticalclusteroftiny,cystic,nodularlesionswithassociatedT2/FLAIRsignalabnormality(andmildlyT1hypointensity).
Theyareusuallyseeninthedeepcorticalribbonandsuperficialsubcorticalwhitematter.
Theyrarelyenhance(approximately3%to10%ofcases)withstippledfaintenhancement.
Theyshouldnotexhibitrestricteddiffusionorabnormalsusceptibility.
Theyrarelyprogress/increaseinsize.
影像表现：
在CT上很难明确病变，可表现为低密度；
在MRI上表现为T2/FLAIR信号异常（T1轻度低信号）的皮层下簇状微小囊性结节性病变；
多见于深部皮质带和浅表皮层下白质；
多无强化，约3％-10％的病例可见点状微弱增强；
无扩散受限或异常磁敏感性；
病灶大小几乎不会进展/增加。
Treatment
Theyareslow-growing/indolent,andifnotassociatedwithrefractoryepilepsy,theyareconsidereda“leavemealone”lesion.
Theyareusuallyjustfollowedwithimaging,buttheycanberesectediftheyareassociatedwithintractableepilepsy.
治疗：
病灶生长缓慢或无变化，如果不与顽固性癫痫相关，被认为是“别管我”病灶。
通常借助影像进行随访，如果与难治性癫痫相关则予以切除。
以上英文病例来自Auntminnie.