Lieb J M, Lonak A, Vogler A, Pruefer F, Ahlhelm F J
Abteilung Neuroradiologie, Klinik für Radiologie und Nuklearmedizin, Departement Theragnostik, Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz.
Kinderradiologie, Universitäts-Kinderspital beider Basel, Basel, Schweiz.
Radiologie (Heidelb). 2023 Aug;63(8):583-591. doi: 10.1007/s00117-023-01159-y. Epub 2023 Jun 12.
Tumors of the posterior fossa account for about 50-55% of brain tumors in childhood.
The most frequent tumor entities are medulloblastomas, pilocytic astrocytomas, ependymomas, diffuse midline gliomas and atypical teratoid-rhabdoid tumors. Neuroradiological differential diagnosis with magnetic resonance imaging (MRI) is of considerable importance for preoperative planning as well as planning of follow-up therapy.
Most important findings for differential diagnosis of pediatric posterior fossa tumors are tumor location, patient age and the intratumoral apparent diffusion assessed by diffusion-weighted imaging.
Advanced MR techniques like MRI perfusion and MR spectroscopy can be helpful both in the initial differential diagnosis and in tumor surveillance, but exceptional characteristics of certain tumor entities should be kept in mind.
Standard clinical MRI sequences including diffusion-weighted imaging are the main diagnostic tool in evaluating posterior fossa tumors in children. Advanced imaging methods can be helpful, but should never be interpreted separately from conventional MRI sequences.
后颅窝肿瘤约占儿童脑肿瘤的50 - 55%。
最常见的肿瘤类型是髓母细胞瘤、毛细胞型星形细胞瘤、室管膜瘤、弥漫性中线胶质瘤和非典型畸胎样横纹肌样肿瘤。磁共振成像(MRI)进行神经放射学鉴别诊断对于术前规划以及后续治疗规划具有相当重要的意义。
小儿后颅窝肿瘤鉴别诊断的最重要发现是肿瘤位置、患者年龄以及通过扩散加权成像评估的肿瘤内表观扩散。
MRI灌注和磁共振波谱等先进的MR技术在初始鉴别诊断和肿瘤监测中都可能有所帮助,但应牢记某些肿瘤类型的特殊特征。
包括扩散加权成像在内的标准临床MRI序列是评估儿童后颅窝肿瘤的主要诊断工具。先进的成像方法可能会有帮助,但绝不应与传统MRI序列分开解读。