Role of Diffusion Mri In Differentiation Between The Common Pediatric Posterior Fossa Brain Tumors.
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 73, Issue 2
Abstract
<strong>Background:</strong> Diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) map provide information on MRI about the cellularity of the tumor and have an important role in the pre-operative differentiation of different tumor types.<br /> <strong>Objective: </strong>The aim of this work is to assess the role of diffusion MRI in differentiation between the most frequently encountered pediatric posterior fossa brain tumors.<br /> <strong>Materials and methods: </strong>Twenty-four patients were prospectively included in this study. They were referred from the Neurosurgery Department. All of them were suspected to have posterior fossa SOL according to the contrast enhanced CT. All patients were subjected to conventional MRI followed by diffusion MR imaging and calculation of the ADC values.<br /> <strong>Results: </strong>Twenty-four children (15 females) were included in the study. Their ages ranged between one and fifteen years old with a mean age of six years. Low-and high-grade tumors could be differentiated by using both absolute ADC values and ratios. Low-grade tumors showed statistically significantly higher ADC values (1.69±0.15 vs. 0.80±0.23) and ratios for tumor versus normal cerebellum (2.17±0.30 vs. 1.14±0.33) and tumor versus brain stem (1.88±0.35 vs. 1.06±0.24).The probability of error at 0.05 was considered significant, while at 0.01 and 0.001 was considered highly significant. Absolute ADC values and cerebellar and brainstem ratios were significantly higher in low-grade astrocytomas than in MBs. Overlap was found between ADC values of ATRTs and MBs.The sensitivity and specificity of a cutoff ADC value of > 1.083 x 10<sup>-3</sup>mm<sup>2</sup>/s for differentiation of pilocytic astrocytomas from MBs and ependymomas were 100%.The sensitivity and specificity of a cutoff ADC value of ≤ 0.847 x 10<sup>-3</sup>mm<sup>2</sup>/s for differentiation of medulloblastomas from PAs and ependymomas were 100%.The sensitivity and specificity of a cutoff ADC value of ≤ 1.083 x 10<sup>-3</sup>mm<sup>2</sup>/s and > 0.847 x 10<sup>-3</sup>mm<sup>2</sup>/s for ependymomas were 100%.<br /> <strong>Conclusion: </strong>The calculation of ADC value in the solid enhancing portion of a tumor is a simple and reliable technique for preoperative differentiation of the most common posterior fossa tumors.<br /> <strong> </strong>
Authors and Affiliations
Eman Helal
Keywords
Related Articles
- EP ID EP584444
- DOI 10.12816/ejhm.2018.12521
- Views 90
- Downloads 0
Epidemiology, Bacteriology and Risk Factors of Surgical Wound Infections: A Systematic Review
<strong>Introduction:</strong> Surgical wound infections are a main cause of hospital associated infections in low income and the second most common cause in high income and resource rich countries. This review aiming at...
Comparing non-operative management and surgical fixation in treatment of clavicle fractures
<strong>Background: </strong>Clavicle fractures are common among males from sport injuries and the non-operative treatment has been indicated as treatment of choice. Recently, delayed healing, pain and shoulder weakness...
General View of Optometrists’ Acceptance of the Orthokeratology Concept in Jeddah, KSA
<strong>Introduction: </strong>Orthokeratology refers to the creation of gas permeable contact lenses that temporarily reshape the cornea to reduce refractive errors such as myopia, hyperopia, and astigmatism without the...
Study of Relationship between G894T Variant of Endothelial Nitric Oxide Synthase Gene and Acute Ischemic Stroke
Background: Cerebral stroke (CS) is considered as one of the major causes of death and disability worldwide. Ischemic stroke is the most common type of stroke in Egypt, as in other countries, accounting for 43% to 79% of...
Comparative Study between Intra-operative Ventilatory Techniques to Prevent Postoperative Pulmonary Complications in Obese Patients Undergoing Laparoscopic Surgery
<strong>Background: </strong>Managing ventilation and oxygenation during laparoscopic procedures in morbidly obese patients undergoing surgery represents many challenges. There is no specific guideline on the ventilation...