Tsai Jeng-Dau, Wei Chang-Ching, Tsao Teng-Fu, Hsiao Yu-Ping, Tsai Henry J, Yang Sheng-Hui, Tsai Min-Ling, Sheu Ji-Nan
School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung, 402, Taiwan.
Department of Pediatrics, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung, 402, Taiwan.
Childs Nerv Syst. 2016 Jan;32(1):89-95. doi: 10.1007/s00381-015-2947-4. Epub 2015 Nov 9.
The most common neurological complications associated with tuberous sclerosis complex (TSC) include intractable seizures that begin in infancy and subependymal giant cell astrocytoma (SEGA) complicated by hydrocephalus with increasing age. Information on SEGA growth of TSC patients is limited. This study aimed to examine the TSC-SEGA growth rates by periodic neuroimaging.
This study evaluated the TSC-SEGA growth rates by serial neuroimaging. Fifty-eight patients with TSC underwent systematic evaluation, including a review of medical history and serial brain neuroimaging.
While magnetic resonance imaging was more sensitive in detecting cortical tubers than computed tomography (73.1 vs. 0 %, p < 0.001), its efficacy in identifying intracranial lesions was comparable to that of computed tomography (96.2 vs. 100 %, p = 0.658). Significant tumor growth was observed in children (p = 0.012) and adults (p = 0.028) during follow-up periods, respectively (median for children 23.5 months, interquartile range 18-40 months and median for adults 23 months, interquartile range 12-34 months). Further, the SEGA growth rate in children was significantly higher than that in adults (75.6 vs. 16.5 %, p = 0.03).
The results of the study show that SEGA has a significantly higher growth rate in children using serial follow-up brain imaging, suggesting the importance of performing follow-up neuroimaging at yearly intervals in childhood to identify and prevent potential comorbidities.
与结节性硬化症（TSC）相关的最常见神经并发症包括始于婴儿期的顽固性癫痫发作以及随着年龄增长而并发脑积水的室管膜下巨细胞星形细胞瘤（SEGA）。关于TSC患者SEGA生长情况的信息有限。本研究旨在通过定期神经影像学检查来评估TSC-SEGA的生长速率。
本研究通过系列神经影像学检查评估TSC-SEGA的生长速率。58例TSC患者接受了系统评估，包括病史回顾和系列脑部神经影像学检查。
虽然磁共振成像在检测皮质结节方面比计算机断层扫描更敏感（73.1%对0%，p<0.001），但其在识别颅内病变方面的效能与计算机断层扫描相当（96.2%对100%，p=0.658）。在随访期间，分别在儿童（p=0.012）和成人（p=0.028）中观察到明显的肿瘤生长（儿童中位数为23.5个月，四分位间距为18 - 40个月；成人为23个月，四分位间距为12 - 34个月）。此外，儿童SEGA的生长速率显著高于成人（75.6%对16.5%，p=0.03）。
该研究结果表明，通过系列随访脑部成像显示儿童SEGA的生长速率显著更高，这表明在儿童期每年进行随访神经影像学检查以识别和预防潜在合并症的重要性。
