Quadrigeminal plate lipoma

Case contributed by Dr Hani Salam

Presentation

Incidental finding.

Patient Data

Age: 8 years
Gender: Male
MRI

MRI brain

MRI of the brain demonstrates a rounded region of intense intrinsic high T1 signal located on the right, in the quadrigeminal plate cistern, abutting the inferior colliculus. On FLAIR and T2 weighted sequences it is also of high signal, with subtle chemical shift artefact seen on T2. On fat saturated sequences it fully attenuates.  

MRI

Annotated chemical shift artefact

T2 weighted image demonstrates chemical shift artefact around the lipoma in the frequency encoding direction (anteroposterior). Note how there is signal loss anteriorly (black arrows) and hyperintensity posteriorly (white arrows). This is the result of inaccurate spatial encoding, resulting in the lipoma being incorrectly placed posterior to its actual location.

It should be noted that this appearance is not seen on gradient echo sequences, where signal drop out will be in all directions. 

Case Discussion

This case demonstrates typical appearances of a quadrigeminal plate lipoma, with prominent chemical shift artefact visible on T2 weighted fast spin echo images. 

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Case information

rID: 8929
Case created: 10th Mar 2010
Last edited: 29th Nov 2015
Tags: brain, lipoma
Inclusion in quiz mode: Included

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