Abstract
Purpose
The lack of a well-recognized normal size criterion for the choroid plexus makes small or diffuse choroid plexus pathologies difficult to recognize. The purpose of this study was to determine the normal size of the choroid plexus in the pediatric population utilizing magnetic resonance imaging (MR) and ultrasound (US). As volume measurement across multiple slices is a laborious process, we wanted to propose a simple clinical tool that is easy to use, reproducible, and quick to obtain measurements.
Methods
This study retrospectively evaluated choroid plexus size in 90 children between the ages of 0 and 16. To determine the choroid plexus thickness, a total of 97 studies (71 MRIs and 26 Ultrasounds) were reviewed, from children without any signs of choroid plexus pathology; 6 measurements were taken from MR studies, and 3 measurements were taken from US studies. Averages and ranges of choroid plexus thickness were computed across age groups and gender.
Results
Across all ages, the mean choroid plexus thickness in the lateral ventricles was found to be 3.4, 3.3, and 3.1 mm in the axial, coronal, and sagittal views; 3.2 mm in the temporal horns; 2.5 mm in the fourth ventricle with the lateral limb of the choroid plexus in the fourth ventricle measuring 11.3 mm in length. No trends were observed with respect to age subgroups or gender.
Conclusion
Choroid plexus thickness on average was 3.2 mm in the lateral ventricles and 2.5 mm in the fourth ventricle.
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References
Berger C, Thiesse P et al (1998) Choroid plexus carcinomas in childhood: clinical features and prognostic factors. Neurosurgery 42(3):470–475
Britz GW, Kim DK et al (1996) Hydrocephalus secondary to diffuse villous hyperplasia of the choroid plexus. Case report and review of the literature. J Neurosurg 85(4):689–691
Cataltepe O, Liptzin D et al (2010) Diffuse villous hyperplasia of the choroid plexus and its surgical management. J Neurosurg Pediatr 5(5):518–522
Cecchi PC, Billio A et al (2008) Primary high-grade B-cell lymphoma of the choroid plexus. Clin Neurol Neurosurg 110(1):75–79
Chitkara U, Cogswell C et al (1988) Choroid plexus cysts in the fetus: a benign anatomic variant or pathologic entity? Report of 41 cases and review of the literature. Obstet Gynecol 72(2):185–189
Coates TL, Hinshaw DB Jr et al (1989) Pediatric choroid plexus neoplasms: MR, CT, and pathologic correlation. Radiology 173(1):81–88
Fujii K, Lenkey C et al (1980) Microsurgical anatomy of the choroidal arteries. Fourth ventricle and cerebellopontine angles. J Neurosurg 52(4):504–524
Goldberg HI, Lavi E, Atlas SW (1996) Extra-axial brain tumors. In: Atlas SW (ed) Magnetic resonance imaging of the brain and spine. Lippincott-Raven, Philadelphia p 480
Griffiths PD, Blaser S et al (1996) Choroid plexus size in young children with Sturge-Weber syndrome. AJNR Am J Neuroradiol 17(1):175–180
Guariglia L, Rosati P (1999) Prevalence and significance of isolated fetal choroid plexus cysts detected in early pregnancy by transvaginal sonography in women of advanced maternal age. Prenat Diagn 19(2):128–131
Guermazi A, De Kerviler E et al (2000) Diagnostic imaging of choroid plexus disease. Clin Radiol 55(7):503–516
Hagiwara E, Nath J (2007) Choroid plexitis in a case of systemic nocardiosis. Emerg Radiol 14(5):337–343
Jain A, Dixit S et al (2010) Large choroid plexus teratoma: a rare cause of congenital hydrocephalus. Indian J Pediatr 77(4):452–453
Janisch W, Staneczek W (1989) Primary tumors of the choroid plexus. Frequency, localization and age. Zentralbl Allg Pathol 135(3):235–240
Kongkham P, Rutka JT (2010) Choroid plexus tumors. In: Tonn JC, Westphal M, Rutka JT (eds) Oncology of CNS tumors. Springer, Germany, pp 587–596
Levine S (1987) Choroid plexus: target for systemic disease and pathway to the brain. Lab Invest 56(3):231–233
Menon G, Nair SN et al (2010) Choroid plexus tumors: an institutional series of 25 patients. Neurol India 58(3):429–435
Mussi AC, Rhoton AL Jr (2000) Telovelar approach to the fourth ventricle: microsurgical anatomy. J Neurosurg 92(5):812–823
Naeini RM, Yoo JH et al (2009) Spectrum of choroid plexus lesions in children. AJR Am J Roentgenol 192(1):32–40
Pear BL (1984) Xanthogranuloma of the choroid plexus. AJR Am J Roentgenol 143(2):401–402
Peleg D, Yankowitz J (1998) Choroid plexus cysts and aneuploidy. J Med Genet 35(7):554–557
Redzic ZB, Segal MB (2004) The structure of the choroid plexus and the physiology of the choroid plexus epithelium. Adv Drug Deliv Rev 56(12):1695–1716
Smith ZA, Moftakhar P et al (2007) Choroid plexus hyperplasia: surgical treatment and immunohistochemical results. Case report. J Neurosurg 107(3 Suppl):255–262
Stimac GK, Solomon MA et al (1986) CT and MR of angiomatous malformations of the choroid plexus in patients with Sturge-Weber disease. AJNR Am J Neuroradiol 7(4):623–627
Strandring S, Borley NR, Collins P, Crossman AR, Gatzoulis MA, Healy JC, Johnson D, Mahadevan V, Newell RLM, Wigley C (eds) (2008) Gray’s anatomy, 40th edn. Churchill Livingstone Elsevier, Spain
Wakai S, Andoh Y et al (1990) Choroid plexus arteriovenous malformation in a full-term neonate. Case report. J Neurosurg 72(1):127–129
Warren DT, Hendson G et al (2009) Bilateral choroid plexus hyperplasia: a case report and management strategies. Childs Nerv Syst 25(12):1617–1622
Wen HT, Rhoton AL Jr et al. (1998) Transchoroidal approach to the third ventricle: an anatomic study of the choroidal fissure and its clinical application. Neurosurgery 42(6):1205–1217; discussion 1217–1209
Yamamoto I, Rhoton AL Jr et al (1981) Microsurgery of the third ventricle: Part I. Microsurgical anatomy. Neurosurgery 8(3):334–356
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Madhukar, M., Choudhary, A.K., Boal, D.K. et al. Choroid plexus: normal size criteria on neuroimaging. Surg Radiol Anat 34, 887–895 (2012). https://doi.org/10.1007/s00276-012-0980-5
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DOI: https://doi.org/10.1007/s00276-012-0980-5