Forbes Jonathan A, Reig Adam S, Smith Jason G, Jermakowicz Walter, Tomycz Luke, Shay Sheila D, Sun David A, Wushensky Curtis A, Pearson Matthew M
Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Pediatr Neurosurg. 2011;47(1):51-9. doi: 10.1159/000329627. Epub 2011 Aug 22.
BACKGROUND/AIMS: The majority of pediatric patients with cerebellar neoplasms harbor pilocytic astrocytomas (PAs), medulloblastomas, or ependymomas. Knowledge of a preoperative likelihood of histopathology in this group of patients has the potential to influence many aspects of care. Previous studies have demonstrated hyperintensity on diffusion-weighted imaging to correlate with medulloblastomas. Recently, measurement of T(2)-weighted signal intensity (T2SI) was shown to be useful in identification of low-grade cerebellar neoplasms. The goal of this study was to assess whether objective findings on these MRI sequences reliably correlated with the underlying histopathology.
We reviewed the radiologic findings of 50 pediatric patients who underwent resection of a cerebellar neoplasm since 2003 at our institution. Region of interest placement was used to calculate the relative diffusion-weighted signal intensity (rDWSI) and relative T2SI (rT2SI) of each neoplasm.
Tukey's multiple comparison test demonstrated medulloblastomas to have significantly higher rDWSIs than PAs/ependymomas, and PAs to have significantly higher rT2SIs than medulloblastomas/ependymomas. A simple method consisting of sequential measurement of rDWSI and rT2SI to predict histopathology was then constructed. Using this method, 39 of 50 (78%) tumors were accurately predicted.
Measurement of rDWSI and rT2SI using standard MRI of the brain can be used to predict histopathology with favorable accuracy in pediatric patients with cerebellar tumors.
背景/目的：大多数患有小脑肿瘤的儿科患者患有毛细胞型星形细胞瘤（PA）、髓母细胞瘤或室管膜瘤。了解该组患者术前组织病理学的可能性有可能影响护理的许多方面。先前的研究表明，扩散加权成像上的高信号与髓母细胞瘤相关。最近，T（2）加权信号强度（T2SI）的测量被证明有助于识别低度小脑肿瘤。本研究的目的是评估这些MRI序列上的客观发现是否与潜在的组织病理学可靠相关。
我们回顾了自2003年以来在我们机构接受小脑肿瘤切除术的50例儿科患者的放射学检查结果。使用感兴趣区域放置来计算每个肿瘤的相对扩散加权信号强度（rDWSI）和相对T2SI（rT2SI）。
Tukey多重比较检验表明，髓母细胞瘤的rDWSI显著高于PA/室管膜瘤，而PA的rT2SI显著高于髓母细胞瘤/室管膜瘤。然后构建了一种由rDWSI和rT2SI的顺序测量组成的简单方法来预测组织病理学。使用这种方法，50个肿瘤中的39个（78%）被准确预测。
使用标准脑部MRI测量rDWSI和rT2SI可用于以良好的准确性预测患有小脑肿瘤的儿科患者的组织病理学。
