Zhang Heng, Liao Zhiyi, Hao Xiaolei, Han Zhe, Li Chunde, Gong Jian, Liu Wei, Tian Yongji
Department of Pediatric Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, Beijing, China.
Childs Nerv Syst. 2019 May;35(5):795-800. doi: 10.1007/s00381-019-04075-6. Epub 2019 Feb 6.
To establish some explicit, feasible, and reproducible predictors for CMS.
This study was a retrospective case study. Data were obtained from 82 patients with medulloblastoma at a single center, Beijing Tiantan Hospital. Based on medical records, we created two independent samples: the CMS group comprising 23 patients and the non-CMS group comprising 23 patients. Pre-operative imaging was studied by performing quantitative assessments of specific indicators.
The CMS group showed greater differences in pre-operative imaging data with the non-CMS group. The A/d ratio in pre-operative MR imaging captured in the axial plane was used to quantify the compression of the cerebellum and brainstem, and significant differences were observed between the CMS group and non-CMS group (p = 0.0002). In the sagittal plane, D*d was used to quantify the area of the tumor that invaded the brainstem, and significant differences were observed between the two groups (p = 0.0003). In the coronal plane, A/d was used to quantify the compression of the upper functional brain region, and significant differences were noted between the two groups (p = 0.0219). Additionally, Evans' index was introduced to quantify the degree of hydrocephalus. The CMS group tended to show an increased Evans' index (p = 0.0027).
Based on pre-operative imaging data, some reproducible predictors, such as A/d, D*d, A/d, and Evans' index, were established.
建立一些明确、可行且可重复的儿童髓母细胞瘤分子亚型（CMS）预测指标。
本研究为回顾性病例研究。数据来自北京天坛医院单中心的82例髓母细胞瘤患者。基于病历，我们创建了两个独立样本：CMS组（23例患者）和非CMS组（23例患者）。通过对特定指标进行定量评估来研究术前影像学资料。
CMS组与非CMS组在术前影像学数据上存在较大差异。采用轴位术前磁共振成像的A/d比值来量化小脑和脑干的受压情况，CMS组与非CMS组之间存在显著差异（p = 0.0002）。在矢状面，用D*d来量化肿瘤侵犯脑干的面积，两组间存在显著差异（p = 0.0003）。在冠状面，用A/d来量化大脑上部功能区的受压情况，两组间存在显著差异（p = 0.0219）。此外，引入Evans指数来量化脑积水程度。CMS组的Evans指数往往升高（p = 0.0027）。
基于术前影像学数据，建立了一些可重复的预测指标，如A/d、D*d、A/d和Evans指数。
