Yiu Eppie M, Laughlin Suzanne, Verhey Leonard H, Banwell Brenda L
1Children's Neuroscience Centre, Royal Children's Hospital Melbourne, Parkville, Australia.
J Child Neurol. 2014 May;29(5):654-65. doi: 10.1177/0883073813500713. Epub 2013 Oct 3.
Tumefactive demyelinating lesions can be difficult to distinguish from tumors. Clinical and magnetic resonance imaging features of children with tumefactive demyelination and supratentorial brain tumors were compared. Patients were identified through a 23-site national demyelinating disease study, and from a single-site neuroradiology database. For inclusion, lesions met at least 1 of 3 criteria: maximal cross-sectional diameter >20 mm, local or global cerebral mass effect, or presence of perilesional edema. Thirty-one children with tumefactive demyelination (5 with solitary lesions) were identified: 27 of 189 (14.3%) from the demyelinating disease study and 4 from the database. Thirty-three children with tumors were identified. Children with tumefactive demyelination were more likely to have an abnormal neurologic examination and polyfocal neurologic deficits compared to children with tumors. Tumefactive demyelination was distinguished from tumor by the presence of multiple lesions, absence of cortical involvement, and decrease in lesion size or detection of new lesions on serial imaging.
瘤样脱髓鞘病变可能难以与肿瘤区分开来。对患有瘤样脱髓鞘和幕上脑肿瘤的儿童的临床和磁共振成像特征进行了比较。通过一项涉及23个地点的全国性脱髓鞘疾病研究以及一个单中心神经放射学数据库确定了患者。纳入标准为：病变至少符合以下3项标准中的1项：最大横截面直径>20毫米、局部或整体脑占位效应或病灶周围水肿。确定了31例患有瘤样脱髓鞘的儿童（5例为孤立性病变）：189例中的27例（14.3%）来自脱髓鞘疾病研究，4例来自数据库。确定了33例患有肿瘤的儿童。与患有肿瘤的儿童相比，患有瘤样脱髓鞘的儿童更有可能出现神经系统检查异常和多灶性神经功能缺损。瘤样脱髓鞘与肿瘤的区别在于存在多个病变、无皮质受累以及在系列成像中病变大小减小或发现新病变。
