Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, South Korea.
Section for Computational Neuroimaging, Department of Neuroradiology, Heidelberg University College of Medicine, Heidelberg, Germany.
J Magn Reson Imaging. 2023 Sep;58(3):690-708. doi: 10.1002/jmri.28740. Epub 2023 Apr 17.
The fifth edition of the World Health Organization (WHO) classification of central nervous system tumors published in 2021 advances the role of molecular diagnostics in the classification of gliomas by emphasizing integrated diagnoses based on histopathology and molecular information and grouping tumors based on genetic alterations. This Part 2 review focuses on the molecular diagnostics and imaging findings of pediatric-type diffuse high-grade gliomas, pediatric-type diffuse low-grade gliomas, and circumscribed astrocytic gliomas. Each tumor type in pediatric-type diffuse high-grade glioma mostly harbors a distinct molecular marker. On the other hand, in pediatric-type diffuse low-grade gliomas and circumscribed astrocytic gliomas, molecular diagnostics may be extremely complicated at a glance in the 2021 WHO classification. It is crucial for radiologists to understand the molecular diagnostics and imaging findings and leverage the knowledge in clinical practice. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 3.
2021 年发布的第五版世界卫生组织(WHO)中枢神经系统肿瘤分类通过强调基于组织病理学和分子信息的综合诊断,并根据遗传改变对肿瘤进行分组,推进了分子诊断在神经胶质瘤分类中的作用。本篇第 2 部分重点介绍了儿童型弥漫性高级别神经胶质瘤、儿童型弥漫性低级别神经胶质瘤和局灶性星形细胞瘤的分子诊断和影像学发现。儿童型弥漫性高级别神经胶质瘤中的每种肿瘤类型通常都具有独特的分子标志物。另一方面,在儿童型弥漫性低级别神经胶质瘤和局灶性星形细胞瘤中,2021 年 WHO 分类乍一看,分子诊断可能极其复杂。放射科医生了解分子诊断和影像学发现并将这些知识应用于临床实践至关重要。证据水平:3 技术功效:3 级。