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Usefulness of Contrast-Enhanced 3D-FLAIR MR Imaging for Differentiating Rathke Cleft Cyst from Cystic Craniopharyngioma.

对比增强3D-FLAIR MR成像对鉴别Rathke裂囊肿和囊性颅咽管瘤的有用性。

  • 影响因子:3.28
  • DOI:10.3174/ajnr.A6359
  • 作者列表:"Azuma M","Khant ZA","Kitajima M","Uetani H","Watanabe T","Yokogami K","Takeshima H","Hirai T
  • 发表时间:2020-01-01
Abstract

BACKGROUND AND PURPOSE:Because it can be difficult to discriminate between a Rathke cleft cyst and cystic craniopharyngioma by conventional MR imaging alone, we investigated whether contrast-enhanced 3D T2-FLAIR MR imaging at 3T helps to distinguish a Rathke cleft cyst from a cystic craniopharyngioma. MATERIALS AND METHODS:We evaluated pre- and postcontrast T1-weighted and 3D T2-FLAIR images of 17 patients with pathologically confirmed Rathke cleft cyst (n = 10) or cystic craniopharyngioma (n = 7). All underwent 3T MR imaging studies before surgery. Two neuroradiologists independently recorded the enhancement grade of the lesion wall as grade 2 (most of the wall enhanced), grade 1 (some of the wall enhanced), and grade 0 (none of the wall enhanced). One neuroradiologist performed a blinded reading study of conventional MR images with/without 3D T2-FLAIR images. Interobserver agreement was determined by calculating the κ coefficient. Statistical analyses, including receiver operating characteristic curve analysis were performed. RESULTS:Interobserver agreement for postcontrast T1WI and 3D T2-FLAIR images was excellent (κ = 0.824 and κ = 0.867, respectively). Although the difference in the mean enhancement grade of Rathke cleft cysts and cystic craniopharyngiomas was not significant on postcontrast T1WIs, it was significant on postcontrast 3D T2-FLAIR images (P = .0011). The area under the receiver operating characteristic curve of the conventional MR alone and conventional MR with 3D T2-FLAIR readings was 0.879 and 1.0, respectively, though there was no significant difference in the area under the curve between the 2 readings. CONCLUSIONS:Contrast-enhanced 3D T2-FLAIR imaging at 3T helps to distinguish a Rathke cleft cyst from cystic craniopharyngioma.

摘要

背景与目的: 由于单纯常规MR成像难以区分Rathke裂囊肿和囊性颅咽管瘤,我们研究了3t增强3D T2-FLAIR MR成像是否有助于区分Rathke裂囊肿和囊性颅咽管瘤。 材料和方法: 我们评估了17例经病理证实的Rathke裂囊肿 (n = 10) 或囊性颅咽管瘤 (n = 7) 的造影前后T1-weighted和3D T2-FLAIR图像。术前均行3T MR影像学检查。两名神经放射科医师独立记录病变壁的增强等级为2级 (壁大部分增强) 、1级 (壁部分增强) 和0级 (壁无增强)。一位神经放射科医师对具有/不具有3D T2-FLAIR图像的常规MR图像进行了盲读研究。通过计算 κ 系数确定观察者间的一致性。进行统计分析,包括受试者操作特征曲线分析。 结果: 对比后T1WI和3D T2-FLAIR图像的观察者间一致性良好 (分别为 κ = 0.824和 κ = 0.867)。虽然Rathke裂囊肿和囊性颅咽管瘤的平均强化等级在对比后t1wi上没有显著差异,但在对比后3D T2-FLAIR图像上有显著差异 (p   =  .0011)。单独的常规MR和具有3D T2-FLAIR读数的常规MR的接受者工作特征曲线下面积分别为0.879和1.0,尽管在2个读数之间曲线下面积没有显著差异。 结论: 3t增强三维T2-FLAIR成像有助于鉴别Rathke裂囊肿和囊性颅咽管瘤。

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影响因子:2.98
发表时间:2020-01-01
DOI:10.1136/neurintsurg-2019-014962
作者列表:["Guo W","Liu H","Tan Z","Zhang X","Gao J","Zhang L","Guo H","Bai H","Cui W","Liu X","Wu X","Luo J","Qu Y"]

METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.

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作者列表:["Meng L","Zhao D","Yang Z","Wang B"]

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