The Value of Diffusion Tensor Imaging in Differential Diagnosis of Embryonal Tumors Occurring in the Brainstem and Brainstem Gliomas in Pediatric Patients

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-02-01 DOI:10.1016/j.pediatrneurol.2024.11.011

Wenjiao Xiao MMed , Shuang Li MMed , Zanyong Tong MMed , Lusheng Li MD , Yuting Zhang MD

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Abstract

Background

There are no apparent distinctions in clinical presentation or conventional imaging findings between brainstem gliomas and embryonal tumors occurring in the brainstem. Our aim was to study the role of diffusion tensor imaging in differentiating embryonal tumors from gliomas of the brainstem.

Methods

Three cases of embryonal tumors occurring in the brainstem and 19 cases of brainstem gliomas were analyzed retrospectively.

Result

The most common brainstem gliomas are diffuse intrinsic pontine gliomas. On the fiber tracking images, brainstem gliomas were associated with relatively intact projection fibers that continuously traversed the tumor and followed the trajectory of normal neural fibers, whereas embryonal tumors were associated with disruption of projection fibers. The close cellularity created tissues with significant directional properties in embryonal tumors, restricting the diffusion of water molecules. As a result, there were areas of high anisotropy within the embryonal tumors. Additionally, we observed that the apparent diffusion coefficient value of embryonal tumors occurring in the brainstem was lower than that of brainstem gliomas and the difference was statistically significant (P < 0.05).

Conclusion

Disruption of projection fibers within the tumor on diffusion tensor imaging may help differentiate embryonal pathology from glial.

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弥散张量成像在小儿脑干胚胎瘤和脑干胶质瘤鉴别诊断中的价值》（The Value of Diffusion Tensor Imaging in Differential Diagnosis of Embryonal Tumors Occurring in the Brainstem and Brainstem Gliomas in Pediatric Patients）。

背景：脑干胶质瘤和发生在脑干的胚胎性肿瘤在临床表现和常规成像结果上没有明显区别。我们的目的是研究弥散张量成像在区分脑干胚胎性肿瘤和胶质瘤中的作用：方法：对3例发生在脑干的胚胎性肿瘤和19例脑干胶质瘤进行回顾性分析：结果：最常见的脑干胶质瘤是弥漫性桥脑胶质瘤。在纤维追踪图像上，脑干胶质瘤与相对完整的投射纤维有关，这些投射纤维连续穿过肿瘤并沿着正常神经纤维的轨迹运动，而胚胎性肿瘤则与投射纤维的中断有关。在胚胎性肿瘤中，紧密的细胞形成了具有明显方向性的组织，限制了水分子的扩散。因此，胚胎肿瘤内存在各向异性较高的区域。此外，我们还观察到，发生在脑干的胚胎瘤的表观扩散系数值低于脑干胶质瘤的表观扩散系数值，且差异有统计学意义（P 结论：胚胎瘤的表观扩散系数值低于脑干胶质瘤的表观扩散系数值：弥散张量成像中肿瘤内投射纤维的中断可能有助于区分胚胎性病变和胶质瘤。

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

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.