A topographical analysis of encephalocele locations: generation of a standardised atlas and cluster analysis.
A topographical analysis of encephalocele locations: generation of a standardised atlas and cluster analysis.
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DOI：
10.1007/s00381-023-05883-7
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发表时间：
2023-07
期刊：
影响因子：
--
通讯作者：
Thompson DNP
中科院分区：
文献类型：
--
作者：
Vakharia VN;Toescu S;Copp AJ;Thompson DNP
脑膨出被认为是由于发育中的颅骨缺陷引起的，脑膜和潜在的脑组织通过该缺陷疝出。这一过程的病理机制还不完全清楚。我们的目的是描述脑膨出的位置，通过生成一组图集，以确定他们是否发生在随机网站或集群内不同的解剖区域。从1984年至2021年前瞻性维护的数据库中确定了诊断为颅内脑膨出或脑膜膨出的患者。使用非线性配准将图像转换到图谱空间。手动分割骨缺损、脑膨出和疝出的脑内容物，以生成脑膨出位置的三维热图。利用K均值聚类机器学习算法对骨缺损的质心进行聚类，其中手肘方法用于确定聚类的最佳数量。在确定的124名患者中，55名患者进行了MRI（48/55）或CT（7/55）形式的体积成像，可用于图谱生成。中位脑膨出体积为14704 [IQR 3655-86746] mm 3，颅骨缺损的中位表面积为679 [IQR 374-765] mm 2。在45%（25/55）的患者中发现脑疝进入脑膨出，中位体积为7433 [IQR 3123-14237] mm 3。手肘法显示3个离散的簇：1）前颅底（22%; 12/55），2）顶枕交界处（45%; 25/55）和3）枕叶周围（33%; 18/55）。聚类分析显示脑膨出部位与性别无相关性[χ2（2，n=91）= 3.86，p = 0.15]。与预期人群频率相比，黑人、亚洲人和其他种族的脑膨出相对比白色种族更常见。51%（28/55）的病例发现镰状窦。镰状窦更常见[χ2（2，n=55）= 6.09，p = 0.05]，而脑疝在顶枕位置不太常见[χ2（2，n=55）= 0.16.24，p < 0.0003]。该分析揭示了脑膨出的三个主要位置，其中顶枕交界处最常见。脑膨出在解剖学上不同的集群和不同的静脉畸形在某些网站的共存的刻板的位置表明，他们的位置不是随机的，并提出了独特的致病机制的可能性，独特的每个这些地区。
Encephaloceles are considered to result from defects in the developing skull through which meninges, and potentially brain tissue, herniate. The pathological mechanism underlying this process is incompletely understood. We aimed to describe the location of encephaloceles through the generation of a group atlas to determine whether they occur at random sites or clusters within distinct anatomical regions. Patients diagnosed with cranial encephaloceles or meningoceles were identified from a prospectively maintained database between 1984 and 2021. Images were transformed to atlas space using non-linear registration. The bone defect, encephalocele and herniated brain contents were manually segmented allowing for a 3-dimensional heat map of encephalocele locations to be generated. The centroids of the bone defects were clustered utilising a K-mean clustering machine learning algorithm in which the elbow method was used to identify the optimal number of clusters. Of the 124 patients identified, 55 had volumetric imaging in the form of MRI (48/55) or CT (7/55) that could be used for atlas generation. Median encephalocele volume was 14704 [IQR 3655-86746] mm3 and the median surface area of the skull defect was 679 [IQR 374-765] mm2. Brain herniation into the encephalocele was found in 45% (25/55) with a median volume of 7433 [IQR 3123-14237] mm3. Application of the elbow method revealed 3 discrete clusters: 1) Anterior skull base (22%; 12/55), 2) Parieto-occipital junction (45%; 25/55) and 3) Peri-torcular (33%; 18/55). Cluster analysis revealed no correlation between the location of the encephalocele with gender [χ2 (2, n=91) = 3.86, p = 0.15]. Compared to expected population frequencies, encephaloceles were relatively more common in Black, Asian and Other compared to White ethnicities. A falcine sinus was identified in 51% (28/55) of cases. Falcine sinuses were more common [χ2 (2, n=55) = 6.09, p = 0.05] whilst brain herniation was less common [χ2 (2, n=55) =.16.24, p < 0.0003] in the parieto-occipital location. This analysis revealed three predominant clusters for the location of encephaloceles, with the parieto-occipital junction being the most common. The stereotypic location of encephaloceles into anatomically distinct clusters and the coexistence of distinct venous malformations at certain sites suggests that their location is not random and raises the possibility of distinct pathogenic mechanisms unique to each of these regions.
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影响因子：
--
作者：
Sencer S;Arnaout MM;Al-Jehani H;Alsubaihawi ZA;Al-Sharshahi ZF;Hoz SS
通讯作者：
Hoz SS
影响因子：
2.1
作者：
Peake JN;Knowles RL;Shawe J;Rankin J;Copp AJ
通讯作者：
Copp AJ
影响因子：
4
作者：
CREASY, MR;ALBERMAN, ED
通讯作者：
ALBERMAN, ED
影响因子：
--
作者：
ORAHILLY, R;MULLER, F
通讯作者：
MULLER, F
影响因子：
5.7
作者：
Fonov V;Evans AC;Botteron K;Almli CR;McKinstry RC;Collins DL;Brain Development Cooperative Group
通讯作者：
Brain Development Cooperative Group