Imaging characteristics and growth of subependymal giant cell astrocytomas.
Imaging characteristics and growth of subependymal giant cell astrocytomas.
复制标题
室管膜下巨细胞星形细胞瘤的影像学特征及生长。
DOI：
10.3171/foc.2006.20.1.6
复制
发表时间：
2006
影响因子：
4.1
通讯作者：
C. Raffel
中科院分区：
文献类型：
--
作者：
M. Clarke;Andrew B. Foy;N. Wetjen;C. Raffel
对象
室管膜下巨细胞星形细胞瘤(SEGAS)是结节性硬化(TS)的常见表现。这些不断演变的肿瘤有导致梗阻性脑积水的倾向，通常是由于门罗孔水平的梗阻。在梗阻发生前区分SEGA和室管膜下结节(SENS)可能会改善与这些肿瘤相关的发病率。在这项研究中，作者的目的是确定单中心儿科人群中已证实的肿瘤的影像特征。
方法
作者回顾了所有在TS患者中获得的记录和图像，在这些患者中，活检样本的结果证明他们的肿瘤是SEGAS。记录出现肿瘤的时间、出现时的体征和症状，以及肿瘤的影像特征。本文对12例经活检证实的14个SEGA进行了回顾分析。对于有症状和神经影像证据的脑积水(41%)、没有脑积水证据的肿瘤生长(33%)和控制不佳的癫痫(25%)建议手术切除。肿瘤切除时直径0.3~4 cm，平均1.9 cm，无肿瘤复发。由于SENS和SEGAS的病理和放射学连续性，仍然很难预测给定的病变是否以及何时会进展。肿瘤生长和对比度增强是神经影像上最常见的进展迹象，可以在梗阻性脑积水发生之前看到。
结论
患有SENS和SEGAS的患者应每隔一年进行一次神经影像随访，如果病变有进展迹象(增强或生长)，应缩短这些间隔，并考虑早期切除。
OBJECT
Subependymal giant cell astrocytomas (SEGAs) are a common manifestation of tuberous sclerosis (TS). These evolving tumors have a propensity to cause obstructive hydrocephalus, usually due to obstruction at the level of the foramen of Monro. Differentiating SEGAs from subependymal nodules (SENs) before obstruction occurs may improve the morbidity associated with these tumors. In this study the authors' aim was to determine imaging characteristics of proven tumors in a single-center pediatric population.
METHODS
The authors retrospectively reviewed all records and images obtained in patients with TS in whom results of biopsy sampling had proven that their tumors were SEGAs. Time to presentation, signs and symptoms at presentation, and imaging characteristics of the evolving tumors were noted. Twelve patients with 14 SEGAs proven by the results of biopsy sampling were reviewed. Resection was recommended for symptomatic and neuroimaging evidence of hydrocephalus (41%), tumor growth without evidence of hydrocephalus (33%), and for poorly controlled seizures (25%). The mean diameter of the tumors at the time of resection was 1.9 cm (range 0.3-4 cm), and no tumor recurred. Because of the pathological and radiographic continuum of SENs and SEGAs, it remains difficult to predict whether and when a given lesion will progress. Tumor growth and contrast enhancement are the most common signs of progression on neuroimages, and may be seen prior to the development of obstructive hydrocephalus.
CONCLUSIONS
Patients with SENs and SEGAs should undergo follow-up neuroimaging at yearly intervals, and if lesions show signs of progression (contrast enhancement or growth), these intervals should be shortened and consideration given to early resection.