Department of Radiology, Shenzhen Children's Hospital, Shenzhen, 518000, China.
Department of Radiology, Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 514000, China.
BMC Med Imaging. 2023 Nov 20;23(1):191. doi: 10.1186/s12880-023-01132-0.
There are no specific magnetic resonance imaging (MRI) features that distinguish pilocytic astrocytoma (PA) from adamantinomatous craniopharyngioma (ACP). In this study we compared the frequency of a novel enhancement characteristic on MRI (called the cut green pepper sign) in PA and ACP.
Consecutive patients with PA (n = 24) and ACP (n = 36) in the suprasellar region were included in the analysis. The cut green pepper sign was evaluated on post-contrast T1WI images independently by 2 neuroradiologists who were unaware of the pathologic diagnosis. The frequency of cut green pepper sign in PA and ACP was compared with Fisher's exact test.
The cut green pepper sign was identified in 50% (12/24) of patients with PA, and 5.6% (2/36) with ACP. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the cut green pepper sign for diagnosing PA were 50%, 94.4%, 85.7% and 73.9%, respectively. There was a statistically significant difference in the age of patients with PA with and without the cut green pepper sign (12.3 ± 9.2 years vs. 5.5 ± 4.4 years, p = 0.035).
The novel cut green pepper sign can help distinguish suprasellar PA from ACP on MRI.
在鉴别毛细胞型星形细胞瘤（PA）与造釉细胞瘤型颅咽管瘤（ACP）时，磁共振成像（MRI）并无特异性特征。本研究比较了 MRI 上一种新的强化特征（称为“青椒切断征”）在 PA 和 ACP 中的出现频率。
对位于鞍上区的连续 PA（n=24）和 ACP（n=36）患者进行分析。2 位神经放射科医生在不知病理诊断的情况下，独立评估增强 T1WI 图像上的“青椒切断征”。PA 和 ACP 中“青椒切断征”的出现频率采用 Fisher 确切检验进行比较。
50%（12/24）的 PA 患者和 5.6%（2/36）的 ACP 患者存在“青椒切断征”。“青椒切断征”诊断 PA 的灵敏度、特异度、阳性预测值（PPV）和阴性预测值（NPV）分别为 50%、94.4%、85.7%和 73.9%。有和无“青椒切断征”的 PA 患者的年龄存在统计学差异（12.3±9.2 岁 vs. 5.5±4.4 岁，p=0.035）。
新的“青椒切断征”有助于在 MRI 上鉴别鞍上区的 PA 和 ACP。
