扩散张量成像显示小儿弥漫性脑桥内在型胶质瘤存在脑桥外扩展。
Diffusion tensor imaging suggests extrapontine extension of pediatric diffuse intrinsic pontine gliomas.
作者信息
Wagner Matthias W, Bell W Robert, Kern Jason, Bosemani Thangamadhan, Mhlanga Joyce, Carson Kathryn A, Cohen Kenneth J, Raabe Eric H, Rodriguez Fausto, Huisman Thierry A G M, Poretti Andrea
机构信息
Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
Eur J Radiol. 2016 Apr;85(4):700-6. doi: 10.1016/j.ejrad.2016.02.004. Epub 2016 Feb 4.
PURPOSE
To apply DTI to detect early extrapontine extension of pediatric diffuse intrinsic pontine glioma along the corticospinal tracts.
METHODS
In children with diffuse intrinsic pontine glioma, low-grade brainstem glioma, and age-matched controls, DTI metrics were measured in the posterior limb of the internal capsule and posterior centrum semiovale. Histological examination was available in one patient.
RESULTS
6 diffuse intrinsic pontine glioma, 8 low-grade brainstem glioma, and two groups of 25 controls were included. In diffuse intrinsic pontine glioma compared to controls, fractional anisotropy was lower in the bilateral posterior limb of the internal capsule, axial diffusivity was lower in the bilateral posterior centrum semiovale and posterior limb of the internal capsule, while radial diffusivity was higher in the bilateral posterior limb of the internal capsule. No significant differences were found between low-grade brainstem glioma and controls. In diffuse intrinsic pontine glioma compared to low-grade brainstem glioma, axial diffusivity was lower in the bilateral posterior limb of the internal capsule. Histological examination in one child showed tumor cells in the posterior limb of the internal capsule.
CONCLUSION
Reduction in fractional anisotropy and axial diffusivity and increase in radial diffusivity in diffuse intrinsic pontine glioma may reflect tumor extension along the corticospinal tracts as shown by histology. DTI may detect early extrapontine tumor extension in diffuse intrinsic pontine glioma before it becomes apparent on conventional MRI sequences.
目的
应用扩散张量成像（DTI）检测儿童弥漫性脑桥内在型胶质瘤沿皮质脊髓束的早期脑桥外扩展。
方法
对患有弥漫性脑桥内在型胶质瘤、低级别脑干胶质瘤的儿童以及年龄匹配的对照组，在内囊后肢和半卵圆中心后份测量DTI指标。有一名患者进行了组织学检查。
结果
纳入6例弥漫性脑桥内在型胶质瘤、8例低级别脑干胶质瘤以及两组各25名对照组。与对照组相比，弥漫性脑桥内在型胶质瘤患者双侧内囊后肢的分数各向异性较低，双侧半卵圆中心后份和内囊后肢的轴向扩散率较低，而双侧内囊后肢的径向扩散率较高。低级别脑干胶质瘤与对照组之间未发现显著差异。与低级别脑干胶质瘤相比，弥漫性脑桥内在型胶质瘤患者双侧内囊后肢的轴向扩散率较低。一名儿童的组织学检查显示内囊后肢有肿瘤细胞。
结论
弥漫性脑桥内在型胶质瘤中分数各向异性降低、轴向扩散率降低以及径向扩散率升高可能反映了如组织学所示的肿瘤沿皮质脊髓束的扩展。DTI可能在弥漫性脑桥内在型胶质瘤的脑桥外肿瘤扩展在传统MRI序列上变得明显之前检测到早期扩展。
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