Intracranial volumetric evaluation in postnatally repaired myelomeningocele infants.

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Child's Nervous System Pub Date : 2024-09-01 Epub Date: 2024-05-07 DOI:10.1007/s00381-024-06444-2

Hiroaki Hashimoto, Naoki Irizato, Osamu Takemoto, Yasuyoshi Chiba

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Abstract

Introduction: Most myelomeningocele (MMC) cases present with ventriculomegaly or hydrocephalus, yet a comprehensive volumetric assessment of MMC intracranial structures is lacking. This study aimed to provide baseline data on intracranial structural volumes immediately after birth in MMC infants who underwent repair surgeries after birth (postnatal repair).

Methods: In this retrospective single-center study, we analyzed 52 MMC infants undergoing postnatal repair, utilizing head computed tomography scans at birth for volumetric assessment. Intracranial volume (ICV), lateral ventricles volume (LVV), choroid plexus volume (CPV), and posterior cranial fossa volume (PCFV) were measured. Hydrocephalus was classified into no hydrocephalus, progressive hydrocephalus, and hydrocephalus at birth. Comparative analysis employed the Wilcoxon rank-sum test. Receiver operating characteristic (ROC) analysis discriminated cases with and without ventriculoperitoneal shunt (VPS).

Results: The median values were 407.50 mL for ICV, 33.18 mL for LVV, 0.67 mL for CPV, and 21.35 mL for PCFV. Thirty-seven cases (71.15%) underwent VPS. ROC analysis revealed an LVV cut-off value of 6.74 mL for discriminating cases with and without VPS. Progressive hydrocephalus showed no significant difference in ICV but significantly larger LVV compared to no hydrocephalus. Hydrocephalus at birth demonstrated statistically larger ICV and LVV compared to the other two types.

Conclusion: Baseline volumetric data were provided, and volumetric analysis exhibited statistical differences among three hydrocephalus types. These findings enhance our understanding of intracranial volumetric changes in MMC, facilitating more objective assessments of MMC cases.

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产后脊髓膜膨出修复婴儿的颅内容积评估。

导言：大多数脊髓脊膜膨出症（MMC）病例都伴有脑室肥大或脑积水，但却缺乏对MMC颅内结构的全面体积评估。本研究旨在提供出生后立即接受修复手术（产后修复）的 MMC 婴儿颅内结构体积的基线数据：在这项回顾性单中心研究中，我们分析了 52 名接受产后修复手术的 MMC 婴儿，利用出生时的头部计算机断层扫描进行容积评估。对颅内容积（ICV）、侧脑室容积（LVV）、脉络丛容积（CPV）和后颅窝容积（PCFV）进行了测量。脑积水分为无脑积水、进行性脑积水和出生时脑积水。比较分析采用 Wilcoxon 秩和检验。受试者操作特征（ROC）分析用于区分有无脑室腹腔分流术（VPS）的病例：ICV 中位值为 407.50 mL，LVV 中位值为 33.18 mL，CPV 中位值为 0.67 mL，PCFV 中位值为 21.35 mL。37 例患者（71.15%）接受了 VPS。ROC 分析显示，6.74 mL 的 LVV 临界值可用于区分有 VPS 和无 VPS 的病例。进行性脑积水与无脑积水相比，ICV 无明显差异，但 LVV 明显增大。出生时脑积水与其他两种类型相比，ICV和LVV在统计学上更大：提供了基线容积数据，容积分析显示三种脑积水类型之间存在统计学差异。这些发现加深了我们对 MMC 颅内容积变化的理解，有助于对 MMC 病例进行更客观的评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child's Nervous System 医学-临床神经学

CiteScore

3.00

自引率

7.10%

发文量

322

审稿时长

3 months

期刊介绍： The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.