比较观察生长性散发性前庭神经鞘瘤时的线性和体积肿瘤测量。

Comparing Linear and Volumetric Tumor Measurements During Observation of Growing Sporadic Vestibular Schwannomas.

机构信息

Department of Otolaryngology-Head & Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.

Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA.

出版信息

Otolaryngol Head Neck Surg. 2023 Sep;169(3):633-641. doi: 10.1002/ohn.290. Epub 2023 Feb 9.

DOI:10.1002/ohn.290

PMID:36758946

Abstract

OBJECTIVE

To assess the correlation between linear and volumetric changes in vestibular schwannomas (VS).

STUDY DESIGN

Retrospective imaging review was performed on patients diagnosed with sporadic VS from 2000 to 2019 who demonstrated linear growth on observation with serial magnetic resonance imaging (MRI).

SETTING

Two large tertiary care centers.

METHODS

Changes in diameter on serial MRI scans, measured by 1995 American Academy of Otolaryngology-Head and Neck Surgery guidelines, were compared to changes in volume, calculated by segmentation.

RESULTS

Ninety-two patients had VS confined to the internal auditory canal (IAC) with 236 MRIs analyzed, and 108 patients had VS involving the cerebellopontine angle (CPA) with 193 MRIs analyzed. The Spearman rank correlation coefficients between changes in diameter and volume for IAC and CPA tumors were 0.43 (p < .001) and 0.65 (p < .001), respectively. Linear diameter increases of 1 to <2 mm corresponded to a median volume change of 32% (interquartile range [IQR]: 6%-86%) for IAC tumors, compared to 23% (IQR: 13%-40%) for CPA tumors. Linear diameter increases of 2 to <3 mm (ie, the minimum linear diameter change classically considered "true growth") corresponded to a median volume change of 42% (IQR: 23%-100%) and 47% (IQR: 26%-69%) for IAC and CPA tumors, respectively.

CONCLUSION

Changes in linear diameter significantly correlated with changes in volume for IAC and CPA tumors, although diameter changes that did not meet the definition of linear growth (<2 mm) had corresponding median volume changes in excess of 20% for both IAC and CPA tumors.

摘要

目的

评估前庭神经鞘瘤（VS）的线性和体积变化之间的相关性。

研究设计

对 2000 年至 2019 年间经诊断患有散发性 VS 且在连续磁共振成像（MRI）检查中显示线性生长的患者进行回顾性影像学检查。

设置

两个大型三级保健中心。

方法

根据 1995 年美国耳鼻喉科学-头颈外科学会指南，比较了连续 MRI 扫描上的直径变化，并通过分割计算了体积变化。

结果

92 例 VS 局限于内听道（IAC），分析了 236 次 MRI，108 例 VS 累及桥小脑角（CPA），分析了 193 次 MRI。IAC 和 CPA 肿瘤的直径变化与体积变化之间的 Spearman 秩相关系数分别为 0.43（p<0.001）和 0.65（p<0.001）。IAC 肿瘤的线性直径增加 1 至<2 mm 对应体积变化的中位数为 32%（四分位距 [IQR]：6%-86%），而 CPA 肿瘤的体积变化中位数为 23%（IQR：13%-40%）。IAC 肿瘤的线性直径增加 2 至<3 mm（即经典上认为“真正生长”的最小线性直径变化）对应体积变化的中位数为 42%（IQR：23%-100%），而 CPA 肿瘤的体积变化中位数为 47%（IQR：26%-69%）。