1Department of Neurosurgery, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan; and.
2Department of Neurological Diagnosis and Restoration, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
J Neurosurg Pediatr. 2023 Sep 8;32(6):627-637. doi: 10.3171/2023.7.PEDS23218. Print 2023 Dec 1.
Pediatric hydrocephalus requires evaluation while accounting for growth of the intracranial structures, but information on choroid plexus growth in children is lacking. This study aimed to create normal growth curves for intracranial volume, choroid plexus volume, and lateral ventricles volume. Additionally, the authors aimed to objectively assess the degree of hydrocephalus caused by choroid plexus hyperplasia (CPH) and to examine the impact of surgical procedures.
This retrospective study analyzed the head CT scans of pediatric patients with minor head trauma treated at Osaka Women's and Children's Hospital between March 2006 and May 2023. The study segmented and calculated intracranial, choroid plexus, and lateral ventricles volumes. The study also calculated the correlation coefficients among these 3 parameters. Patients aged 0 to 10 years were divided into 15 age-related clusters, and mean ± SD values were calculated for each cluster. Growth curves were created by plotting mean values sequentially. Volume obtained from patients with CPH were z-normalized using mean and SD values and compared.
A total of 229 CT scans (94 from females) were analyzed, and positive correlations were observed among intracranial volume, choroid plexus volume, and lateral ventricles volume, with the strongest correlation between the choroid plexus and lateral ventricles volumes. The growth rate of intracranial volume was rapid until approximately 20 months of age, while those of choroid plexus volume and lateral ventricles volume increased rapidly until approximately 1 year of age. Subsequently, choroid plexus volume and lateral ventricles volume plateaued at 1.5 ml and 10 ml, respectively. Three patients with CPH were enrolled and quantitatively evaluated on the basis of the z-normalized volume. Notable abnormal volumes of the choroid plexus (range z-normalized values 24.11-51.17) and lateral ventricles (46.78-122.36) were observed. In 2 patients, improvements in the z-normalized values of intracranial volume and lateral ventricles volume were observed after surgical interventions. Additionally, in 1 patient, choroid plexus volume was reduced by approximately 24% (range z-normalized values 51.17-38.93) after bilateral endoscopic plexus coagulation.
This study provides normal growth curves for intracranial volume, choroid plexus volume, and lateral ventricles volume. Knowledge of these normal values holds the potential for objective assessment of abnormal values associated with hydrocephalus and choroid plexus diseases such as CPH.
小儿脑积水需要在考虑颅内结构生长的情况下进行评估，但目前缺乏儿童脉络丛生长的相关信息。本研究旨在绘制颅内容积、脉络丛容积和侧脑室容积的正常生长曲线。此外，作者旨在客观评估脉络丛增生（CPH）引起的脑积水程度，并研究手术干预的影响。
本回顾性研究分析了 2006 年 3 月至 2023 年 5 月期间在大阪妇女儿童医院接受轻微头部创伤治疗的儿科患者的头部 CT 扫描。研究对颅内、脉络丛和侧脑室容积进行了分割和计算。研究还计算了这 3 个参数之间的相关系数。0 至 10 岁的患者被分为 15 个年龄相关的群组，每个群组计算平均值±标准差。通过依次绘制平均值来创建生长曲线。使用平均值和标准差对 CPH 患者的容积进行 z 标准化，并进行比较。
共分析了 229 次 CT 扫描（94 次来自女性），观察到颅内容积、脉络丛容积和侧脑室容积之间存在正相关，脉络丛和侧脑室容积之间的相关性最强。颅内容积的生长速度在大约 20 个月前较快，而脉络丛容积和侧脑室容积的生长速度在大约 1 岁前较快。随后，脉络丛容积和侧脑室容积分别在 1.5ml 和 10ml 处达到平台期。本研究纳入了 3 名 CPH 患者，并根据 z 标准化容积进行了定量评估。观察到脉络丛（z 标准化值范围 24.11-51.17）和侧脑室（46.78-122.36）的显著异常体积。在 2 名患者中，手术干预后颅内容积和侧脑室容积的 z 标准化值得到改善。此外，在 1 名患者中，双侧内镜脉络丛凝固后，脉络丛体积减少了约 24%（z 标准化值范围 51.17-38.93）。
本研究提供了颅内容积、脉络丛容积和侧脑室容积的正常生长曲线。了解这些正常值有潜力对脑积水和脉络丛疾病（如 CPH）相关的异常值进行客观评估。
