Morsani College of Medicine, Department of Neurosurgery and Brain Repair, Tampa General Hospital, University of South Florida, Tampa, Florida, USA.
University of South Florida Morsani College of Medicine, Department of General Surgery, Tampa General Hospital, Tampa, Florida, USA.
Br J Neurosurg. 2022 Dec;36(6):712-719. doi: 10.1080/02688697.2022.2102147. Epub 2022 Aug 1.
Preoperative compression of middle cerebellar peduncle (MCP) is often observed in vestibular schwannomas. Its re-expansion is expected after tumour resection, however, frequently its thickness remains unchanged or undergoes further atrophy. Similarly, increased MCP FLAIR signal is often observed and thought to be associated with intraoperative MCP injury. This study investigates the dynamics of MCP FLAIR signal changes over time and their implications in long-term MCP atrophy.
Retrospective analysis of patients operated between 2011 and 2019 was performed. Measurements of FLAIR signals and MCP thickness were performed preoperatively, postoperatively and at follow-up.
28 patients (15 females, mean age 51.94 years) were included. The mean follow-up was 23.98 months. The mean tumour size was 2.99 cm. The MCP FLAIR signal was elevated preoperatively in 10 (35.7%) patients and further increased postoperatively in 22 (78.6%), followed by its decrease at follow up (7 patients, 25%). An immediate postoperative re-expansion of middle cerebellar peduncle was observed in 24 (85.7%) patients. No association between tumour size and preoperative FLAIR was established, however tumour size was negatively associated with the MCP thickness. A significant negative association between a postoperative FLAIR and follow-up thickness ( < 0.001) was noted, even if controlling for tumour size and both tumour size and preoperative MCP thickness.
In patients with vestibular schwannomas undergoing surgical resection, the middle cerebellar peduncle FLAIR signal seems to associated with long term thickness of MCP, regardless of its initial size, however does not seem to correlate with the clinical outcome.
术前小脑脑桥脚（MCP）受压在听神经瘤中经常观察到。肿瘤切除后，MCP 预计会重新扩张，但通常其厚度保持不变或进一步萎缩。同样，MCP FLAIR 信号增加也经常观察到，并被认为与术中 MCP 损伤有关。本研究调查了 MCP FLAIR 信号随时间的变化动态及其对长期 MCP 萎缩的影响。
对 2011 年至 2019 年期间手术的患者进行回顾性分析。在术前、术后和随访时测量 FLAIR 信号和 MCP 厚度。
纳入 28 例患者（女性 15 例，平均年龄 51.94 岁）。平均随访时间为 23.98 个月。肿瘤平均大小为 2.99cm。10 例（35.7%）患者术前 MCP FLAIR 信号升高，22 例（78.6%）患者术后信号进一步升高，随后在随访时下降（7 例，25%）。24 例（85.7%）患者术后即刻观察到 MCP 重新扩张。术前 FLAIR 与肿瘤大小之间无相关性，但肿瘤大小与 MCP 厚度呈负相关。术后 FLAIR 与随访时厚度呈显著负相关（<0.001），即使控制了肿瘤大小和肿瘤大小及术前 MCP 厚度。
在接受手术切除的听神经瘤患者中，小脑脑桥脚 FLAIR 信号似乎与 MCP 的长期厚度相关，而与初始大小无关，但似乎与临床结果无关。
