Al-Holou Wajd N, Yew Andrew Y, Boomsaad Zackary E, Garton Hugh J L, Muraszko Karin M, Maher Cormac O
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan 48109-5338, USA.
J Neurosurg Pediatr. 2010 Jun;5(6):578-85. doi: 10.3171/2010.2.PEDS09464.
Arachnoid cysts are a frequent finding on intracranial imaging in children. The prevalence and natural history of these cysts are not well defined. The authors studied a large consecutive series of children undergoing MR imaging to better define both the MR imaging-demonstrated prevalence and behavior of these lesions over time.
The authors reviewed a consecutive series of 11,738 patients who were 18 years of age or younger and had undergone brain MR imaging at a single institution during an 11-year period. In the patients in whom intracranial arachnoid cysts were identified, clinical and demographic information was recorded and imaging characteristics, such as cyst size and location, were evaluated. Prevalence data were analyzed using univariate and multivariate logistic regression, linear regression, and ANOVA. All patients with sufficient data (repeat MR imaging studies as well as repeated clinical evaluation over at least 5 months) for a natural history analysis were identified. This group was assessed for any change in symptoms or imaging appearance during the follow-up interval.
Three hundred nine arachnoid cysts (2.6% prevalence rate) were identified. There was an increased prevalence of arachnoid cysts in males (p < 0.000001). One hundred eleven patients met all criteria for inclusion in the natural history analysis. After a mean follow-up of 3.5 years, 11 arachnoid cysts increased in size, 13 decreased, and 87 remained stable. A younger age at presentation was significantly associated with cyst enlargement (p = 0.001) and the need for surgery (p = 0.05). No patient older than 4 years of age at the time of initial diagnosis had cyst enlargement, demonstrated new symptoms, or underwent surgical treatment.
Arachnoid cysts are a common incidental finding on intracranial imaging in pediatric patients. An older age at the time of presentation is associated with a lack of clinical or imaging changes over time.
蛛网膜囊肿是儿童颅内影像学检查中常见的发现。这些囊肿的患病率和自然史尚不明确。作者研究了一大组连续接受磁共振成像（MR）检查的儿童，以更好地确定MR成像显示的这些病变的患病率及其随时间的变化情况。
作者回顾了11年间在单一机构接受脑部MR成像检查的11738例18岁及以下患者的连续系列病例。对于确诊为颅内蛛网膜囊肿的患者，记录其临床和人口统计学信息，并评估囊肿大小和位置等影像学特征。使用单变量和多变量逻辑回归、线性回归和方差分析对患病率数据进行分析。确定所有有足够数据（至少5个月的重复MR成像研究以及重复的临床评估）进行自然史分析的患者。对该组患者在随访期间的症状或影像学表现的任何变化进行评估。
共发现309个蛛网膜囊肿（患病率为2.6%）。男性蛛网膜囊肿的患病率更高（p < 0.000001）。111例患者符合纳入自然史分析的所有标准。平均随访3.5年后，11个蛛网膜囊肿增大，13个缩小，87个保持稳定。发病时年龄较小与囊肿增大（p = 0.001）和手术需求（p = 0.05）显著相关。初次诊断时年龄大于4岁的患者中，没有囊肿增大、出现新症状或接受手术治疗的情况。
蛛网膜囊肿是儿科患者颅内影像学检查中常见的偶然发现。发病时年龄较大与随时间推移缺乏临床或影像学变化相关。
