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Bochdalek’s flower basket: applied neuroimaging morphometry and variants of choroid plexus in the cerebellopontine angles

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Abstract

Introduction

Protrusions of fourth ventricular choroid plexus through the foramina of Luschka are called ‘Bochdalek’s flower basket’ (BochFB). The bulbous terminal expansions (cornucopiae) extend into the cerebellopontine angle (CPA) cisterns. We studied and reviewed the normal imaging anatomy, morphometry and anatomical variants of BochFB.

Methods

We retrospectively analysed normal brain imaging findings on axial pre- and post-contrast CT scans and enhanced axial T1-weighted MRIs of 200 patients. We assessed BochFB for: (a) calcification, (b) lateral extension, (c) enhancement pattern, (d) cornucopiae shape, (e) symmetry and (f) proximity to tortuous vertebral arteries and morphometry of cornucopiae size and length of BochFB limbs.

Results

BochFB calcification was found in 38 % of patients aged over 51 years. Lateral extension of BochFB into the CPA cistern was prominent in 75 % on CT and 96 % on MRI. The mean length of these extensions was 23.6 mm. BochFB enhanced strongly in 47 % on CT and 66 % on MRI. The BochFB cornucopiae were bulbous in 51 % on CT and 54 % on MRI. The mean width of bulbous cornucopiae was 3.5 mm. Bilateral BochFB symmetry was found in 71 % on CT and 80 % on MRI. Six to 8 % of tortuous left vertebral arteries were close to BochFB.

Conclusion

The cornucopiae are particularly well demonstrated on post-contrast MRI. However several sources of error in image interpretation may arise when imaging the normal BochFB on routine head CT and MRI. Difficulties in analysis arise especially on CT because of physiologic calcification, asymmetry, and the bulbous cornucopiae being mistaken for aneurysms.

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Acknowledgment

TFM was supported by the NIHR Cambridge Biomedical Research Center.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Addenbrooke’s Hospital, Cambridge, UK

    Avril Horsburgh & Tarik F. Massoud

  2. Department of Neurosurgery, Addenbrooke’s Hospital, Cambridge, UK

    Ramez W. Kirollos

  3. Department of Radiology, University of Cambridge, Cambridge, UK

    Tarik F. Massoud

  4. University Department of Radiology, Addenbrooke’s Hospital, University of Cambridge School of Clinical Medicine, Box 218, Hills Road, Cambridge, CB2 2QQ, UK

    Tarik F. Massoud

Authors
  1. Avril Horsburgh
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  2. Ramez W. Kirollos
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  3. Tarik F. Massoud
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Correspondence to Tarik F. Massoud.

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Horsburgh, A., Kirollos, R.W. & Massoud, T.F. Bochdalek’s flower basket: applied neuroimaging morphometry and variants of choroid plexus in the cerebellopontine angles. Neuroradiology 54, 1341–1346 (2012). https://doi.org/10.1007/s00234-012-1065-1

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  • DOI: https://doi.org/10.1007/s00234-012-1065-1

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