Al-Holou Wajd N, Maher Cormac O, Muraszko Karin M, Garton Hugh J L
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan 48109-5338, USA.
J Neurosurg Pediatr. 2010 Feb;5(2):162-6. doi: 10.3171/2009.9.PEDS09297.
The authors reviewed their experience with pediatric pineal cysts to define the natural history and clinical relevance of this common intracranial finding.
The authors identified all patients with pineal cysts who had been clinically evaluated at their institution over an 11.5-year interval and were < 25 years of age at the time of diagnosis. All inclusion criteria were met in 106 patients, and included repeated MR imaging as well as repeated clinical evaluation over at least a 6-month interval.
The mean age at diagnosis was 11.7 +/- 7.2 years. Forty-two patients were male and 64 were female. On follow-up MR imaging evaluation at a mean interval of 3.0 years from the initial study, 98 pineal cysts had no increase in size and no change in imaging appearance. Six pineal cysts increased in size and 2 others had a change in imaging characteristics without associated growth. Younger age was associated with cyst change or growth on follow-up imaging (p = 0.02). The mean age of patients with cysts that changed or grew was 5.5 years, and the mean age of patients with stable pineal cysts was 12.2 years. Initial cyst size and appearance on MR imaging were not significant predictors of growth or change in imaging appearance at follow-up. Similarly, the patient's sex was not a significant predictor of growth or change in imaging characteristics.
Follow-up imaging and neurosurgical evaluation may be considered optional in older children with pineal cysts.
作者回顾了他们在小儿松果体囊肿方面的经验，以明确这一常见颅内病变的自然病程及临床意义。
作者确定了所有在其机构接受临床评估的松果体囊肿患者，这些患者在11.5年的时间间隔内被诊断，诊断时年龄小于25岁。106例患者符合所有纳入标准，包括重复的磁共振成像以及至少6个月间隔的重复临床评估。
诊断时的平均年龄为11.7±7.2岁。42例为男性，64例为女性。在距初始研究平均3.0年的随访磁共振成像评估中，98个松果体囊肿大小未增加，影像学表现无变化。6个松果体囊肿大小增加，另外2个囊肿影像学特征有改变但无相关生长。年龄较小与随访成像时囊肿变化或生长相关（p = 0.02）。囊肿发生变化或生长的患者平均年龄为5.5岁，松果体囊肿稳定的患者平均年龄为12.2岁。磁共振成像上初始囊肿大小和表现不是随访时生长或影像学表现变化的显著预测因素。同样，患者性别也不是影像学特征生长或变化的显著预测因素。
对于年龄较大的松果体囊肿患儿，随访成像和神经外科评估可考虑为非必需。
