Harrison S K, Ditchfield M R, Waters K
Department of Radiology, Royal Children's Hospital, Melbourne, 3051 Victoria, Australia.
Pediatr Radiol. 1998 Aug;28(8):571-4. doi: 10.1007/s002470050417.
Medulloblastoma frequently spreads to involve the spinal cord, which significantly reduces patient survival and determines whether chemotherapy is utilised and the dose of irradiation to the neuraxis. Staging is usually achieved by MRI of the spine and/or cytology of CSF, both methods having their limitations. Objective. To determine whether there is a correlation between CSF cytology and the demonstration of spinal metastases by MRI and whether CSF cytology is useful when spinal MRI is equivocal.
All cases of medulloblastoma diagnosed at our hospital between 1992 and 1997 were identified. Of 26 cases, 11 presentations (age range 4 months to 12 years) had both CSF cytology (either from the cisterna magna or lumbar puncture) and spinal MRI. The MR studies were reviewed for the presence of metastases and the CSF cytology for the presence of tumour cells.
We found 100% correlation between MRI and CSF cytology for samples taken by lumbar puncture (four negative and three positive on both investigations). No correlation was demonstrated when CSF samples were taken from the cisterna magna. Conclusions. Our data suggest that lumbar CSF cytology may be useful when the MRI is equivocal for the presence of metastatic involvement of the spine by medulloblastoma.
髓母细胞瘤常扩散至脊髓，这会显著降低患者生存率，并决定是否采用化疗以及对神经轴的照射剂量。分期通常通过脊柱磁共振成像（MRI）和/或脑脊液细胞学检查来实现，这两种方法都有其局限性。目的：确定脑脊液细胞学检查与MRI显示脊髓转移之间是否存在相关性，以及当脊柱MRI结果不明确时脑脊液细胞学检查是否有用。
确定1992年至1997年在我院诊断的所有髓母细胞瘤病例。26例病例中，11例（年龄范围4个月至12岁）同时进行了脑脊液细胞学检查（通过枕大池或腰椎穿刺获取）和脊柱MRI检查。对MR研究进行回顾以确定是否存在转移，对脑脊液细胞学检查结果进行分析以确定是否存在肿瘤细胞。
我们发现通过腰椎穿刺获取的样本，MRI与脑脊液细胞学检查结果的相关性为100%（两项检查中四项为阴性，三项为阳性）。当从枕大池获取脑脊液样本时，未显示出相关性。结论：我们的数据表明，当MRI对髓母细胞瘤脊柱转移受累情况的结果不明确时，腰椎脑脊液细胞学检查可能有用。
