E1470. Plumbing Complications: Radiologic Review of Intraventricular Lesions
  1. Mohammed Alshehri; MCW
The purpose of this presentation is a quick review of common intraventricular lesions, as radiology trainees should be able to identify them and know how to differentiate them based on patient age, location, and imaging characteristics. *Embryologic anatomy of the ventricular system: 1. The ventricular system embryologically originates as an outpouching from the cranial end of the neural tube. 2. The invagination of pia and vessels into the ventricular system develops the choroid plexus. 3. The ventricles are lined by ependymal cells, with a subependymal pate composed of glial cells.

Educational Goals / Teaching Points
Basic review of the ventricular system, especially as it relates to intraventricular lesions. To present case examples of both common and uncommon mass lesions within the ventricular system to reflect a wide array of pathology. To give a differential diagnosis of ventricular lesions with discussing of associated clinical features and relevant epidemiologic information. Guide the audience to use specific imaging features, patient demography, and lesion location to give a meaningful differential diagnosis to the patient and the referring clinician.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We are dividing our lesions into 4 categories: Neoplastic: *Intraventricular meningioma. *Choroid plexus papilloma/choroid plexus carcinoma. *Choroid plexus metastases. *Ependymoma. *Central neurocytoma. *Subependymoma. *Subependymal giant cell astrocytoma/subependymal hamartomas of tuberous sclerosis. Parynchmal with intraventricular involvement: *Pilocytic astrocytoma. *Atypical teratoid/rhabdoid tumor. *Pineal region masses. *Medulloblastoma. *Hemangioblastoma. Benign lesions: *Cavum septum pellucidum. *Cavum vergae. *Cavum velum interpositum. *Colloid cyst. *Choroid plexus xanthogranuloma. Infectious: *Tuberculoma. *Neurocysticercosis. We will be presenting examples of some of them with characteristic imaging appearance and location to help with the audience's differential diagnosis.

Start with a broad differential for intraventricular lesions and try to narrow it down with their imaging characteristic, lesion location, and patient age. Understand that differentiation between them can be difficult, and giving a wide differential diagnosis sometimes is needed. It is crucial to have excellent communication with treating clinicians to have a better diagnostic approach.