From the Department of Neurosurgery (W.H., J.C., Y.X., H.W., Z.W., D.K.), The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
The First Clinical Medical College of Fujian Medical University (W.H., J.C., Y.X., H.W., Z.W., D.K.), Fuzhou, Fujian, China.
AJNR Am J Neuroradiol. 2021 Dec;42(12):2152-2159. doi: 10.3174/ajnr.A7324. Epub 2021 Nov 1.
Compared with wild-type pleomorphic xanthoastrocytoma, -mutant pleomorphic xanthoastrocytoma showed a higher survival rate. In this study, we focused on finding preoperative MR imaging differences between mutant and wild-type in pleomorphic xanthoastrocytoma and anaplastic pleomorphic xanthoastrocytoma.
Twenty-three patients with pathologically confirmed pleomorphic xanthoastrocytoma or anaplastic pleomorphic xanthoastrocytoma in our hospital were retrospectively analyzed from January 2015 to December 2020. They were divided into a -mutant group (including 6 pleomorphic xanthoastrocytomas and 5 anaplastic pleomorphic xanthoastrocytomas) and a wild-type group (including 8 pleomorphic xanthoastrocytomas and 4 anaplastic pleomorphic xanthoastrocytomas). The preoperative MR imaging characteristics of these groups were statistically compared.
The wild-type pleomorphic xanthoastrocytoma group presented with more aggressive conventional and advanced MR imaging features than the mutant pleomorphic xanthoastrocytoma group, including greater mean maximum tumor diameter (3.1 [SD, 0.9] cm versus 1.7 [SD, 0.4 ] cm, < .05), more frequent heterogeneous contrast enhancement of solid portions (100% versus 0%, < .001), more obvious peritumoral edema (mean, [2.1 SD, 0.7] cm versus 0.6 [SD, 0.2] cm, < .01), and lower mean minimum relative ADC (896 [SD, 86] versus 988 [SD, 73], < .05) and mean relative ADC (1060 [SD, 159] versus 1248 [SD, 116], < .05) on DWI. However, there was no significant difference in either conventional or advanced MR imaging features between the wild-type anaplastic pleomorphic xanthoastrocytoma group and the mutant anaplastic pleomorphic xanthoastrocytoma group.
Neurosurgeons should carefully interpret MR images before an operation and select appropriate surgical strategies according to genotype prediction.
与野生型多形性黄色星形细胞瘤相比，-突变型多形性黄色星形细胞瘤的生存率更高。在本研究中，我们专注于寻找多形性黄色星形细胞瘤和间变性多形性黄色星形细胞瘤中突变型和野生型之间术前磁共振成像（MR）的差异。
回顾性分析 2015 年 1 月至 2020 年 12 月我院经病理证实的 23 例多形性黄色星形细胞瘤或间变性多形性黄色星形细胞瘤患者，分为 -突变组（包括 6 例多形性黄色星形细胞瘤和 5 例间变性多形性黄色星形细胞瘤）和野生型组（包括 8 例多形性黄色星形细胞瘤和 4 例间变性多形性黄色星形细胞瘤）。对这些组的术前 MR 成像特征进行了统计学比较。
与 -突变型多形性黄色星形细胞瘤组相比，野生型多形性黄色星形细胞瘤组具有更具侵袭性的常规和高级 MR 成像特征，包括更大的平均最大肿瘤直径（3.1[SD，0.9]cm 与 1.7[SD，0.4]cm，<0.05）、实性部分更频繁的不均匀对比增强（100%与 0%，<.001）、更明显的瘤周水肿（平均值，[2.1SD，0.7]cm 与 0.6[SD，0.2]cm，<.01）和更低的平均最小相对 ADC 值（896[SD，86]与 988[SD，73]，<0.05）和平均相对 ADC 值（1060[SD，159]与 1248[SD，116]，<0.05）在弥散加权成像（DWI）上。然而，野生型间变性多形性黄色星形细胞瘤组与 -突变型间变性多形性黄色星形细胞瘤组之间的常规或高级 MR 成像特征均无显著差异。
神经外科医生在手术前应仔细解读磁共振图像，并根据基因型预测选择合适的手术策略。
