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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >MR characteristics of malignant spinal cord astrocytomas in children.
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MR characteristics of malignant spinal cord astrocytomas in children.

机译：儿童恶性脊髓星形细胞瘤的MR特征。

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OBJECTIVE: Malignant spinal cord astrocytomas are rare tumors and their specific MR characteristics have not been previously described. We present a detailed MR analysis of four children with malignant astrocytoma. METHODS: A review of the clinical database at the Hospital for Sick Children, Toronto revealed four patients with histologically-verified malignant spinal cord astrocytomas (WHO Grade 3 or 4) with pre-operative MR available for retrospective review. RESULTS: There were three boys and one girl with a mean age at presentation of four years (range 7 months-12 years). Mean duration of symptoms prior to presentation was six weeks (range 3 days-5 months). Pre-operative MR analysis revealed that all tumors were located in the cervical or cervico-thoracic regions and expanded the cord over an average of 6.5 vertebral levels. The signal was usually hypointense on T1-weighted and hyperintense or mixed intensity on T2-weighted images. In the three cases where gadolinium was given, all demonstrated enhancement (one rim enhancement with a discrete border and two with inhomogeneous central enhancement). One tumor appeared to be exophytic, one had a significant cystic component, and none showed evidence of hemorrhage. Pre-operative leptomeningeal spread of tumor was documented in two of four cases and involved intracranial spread in both cases. CONCLUSIONS: There did not appear to be any specific MR characteristics to help differentiate a malignant astrocytoma from a low-grade tumor, except for the high rate of leptomeningeal spread at presentation. It is recommended that full neuraxis MR imaging be performed pre-operatively in children in whom a rapidly progressive clinical course suggests a malignant lesion. This will likely have a high positive yield and provide valuable information prior to surgical intervention.
机译：目的：恶性脊髓星形细胞瘤是罕见的肿瘤，其特异性MR特征以前没有描述。我们对四名恶性星形细胞瘤儿童进行详细的MR分析。方法：对多伦多病童医院临床数据库的回顾显示，有4例经组织学检查证实为恶性脊髓星形细胞瘤（WHO 3或4级）的患者，术前MR可进行回顾性审查。结果：有3个男孩和1个女孩，平均年龄为4岁（7个月至12岁）。出现症状前的平均病程为六周（范围为3天至5个月）。术前MR分析显示，所有肿瘤均位于宫颈或宫颈胸腔区域，并在平均6.5个椎骨水平上扩展了脊髓。在T1加权的信号上通常是低信号，在T2加权的图像上信号是高强度或混合强度。在三种使用g的情况下，所有病例均表现出增强作用（一种边缘增强，边界不连续，另外两种中心增强不均匀）。一种肿瘤似乎是外生性的，一种肿瘤具有明显的囊性成分，没有一种显示出血的迹象。四例中有两例记录了术前肿瘤在脑膜周围的扩散，两例均涉及颅内扩散。结论：除了表现出高的软脑膜扩散率外，似乎没有任何特定的MR特征可帮助区分恶性星形细胞瘤和低度恶性肿瘤。建议在快速进展的临床过程提示恶性病变的患儿术前进行完整的神经磁共振成像。这将可能有很高的阳性收率，并在手术干预之前提供有价值的信息。

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