Abstract：
In this study, the authors aimed to investigate the relationship between postoperative MRI features and cerebellar mutism syndrome.
A retrospective cohort of patients who underwent tumor resection from July 2013 to March 2021 for midline posterior fossa tumors was investigated. All patients were followed up at least once. Clinical data were extracted from medical records and follow-up databases. Two neuroradiologists independently reviewed preoperative and postoperative MRI. Univariable and multivariable analyses were performed to compare the postoperative cerebellar mutism syndrome (pCMS) and non-pCMS groups. Correlation analysis was performed using the Spearman correlation coefficient analysis.
Of 124 patients, 47 (37.9%) developed pCMS. The median follow-up duration was 45.73 (Q1: 33.4, Q3: 64.0) months. The median duration of mutism was 45 days. The median tumor size was 48.8 (Q1: 42.1, Q3: 56.8) mm. In the univariable analysis, abnormal T2-weighted signal of the left dentate nucleus (DN) (74.5% in the pCMS group vs 36.4% in the non-pCMS group, p < 0.001), right DN (83.0% vs 40.3%, p < 0.001), left superior cerebellar peduncle (SCP) (74.5% vs 27.3%, p < 0.001), right SCP (63.8% vs 23.4%, p < 0.001), left middle cerebellar peduncle (MCP) (51.1% vs 26.0%, p = 0.008), and right MCP (61.7% vs 26.0%, p < 0.001); male sex (83.0% vs 45.5%, p < 0.001); vermis 3 impairment (49.4% vs 19.1%, p = 0.002); solid tumor (91.5% vs 72.7%, p = 0.022); and hydrocephalus (72.3% vs 45.5%, p = 0.006) were more frequent in the pCMS group than in the non-pCMS group. Multivariable logistic analysis showed that male sex (adjusted OR 4.08, p = 0.010) and the cerebro-cerebellar circuit score of T2-weighted images (adjusted OR 2.15, p < 0.001) were independent risk factors for pCMS. The cerebro-cerebellar circuit score positively correlated with the duration of mutism. In Cox regression analysis, the cerebro-cerebellar integrated circuit injury score of T2 (adjusted HR 0.790, 95% CI 0.637-0.980; p = 0.032) and injury of vermis 3 (adjusted HR 3.005, 95% CI 1.197-7.547; p = 0.019) were independently associated with the duration of mutism.
Male sex and cerebro-cerebellar circuit damage are independent risk factors for pCMS. The cerebro-cerebellar circuit score indicates the duration of mutism.
A retrospective cohort of patients who underwent tumor resection from July 2013 to March 2021 for midline posterior fossa tumors was investigated. All patients were followed up at least once. Clinical data were extracted from medical records and follow-up databases. Two neuroradiologists independently reviewed preoperative and postoperative MRI. Univariable and multivariable analyses were performed to compare the postoperative cerebellar mutism syndrome (pCMS) and non-pCMS groups. Correlation analysis was performed using the Spearman correlation coefficient analysis.
Of 124 patients, 47 (37.9%) developed pCMS. The median follow-up duration was 45.73 (Q1: 33.4, Q3: 64.0) months. The median duration of mutism was 45 days. The median tumor size was 48.8 (Q1: 42.1, Q3: 56.8) mm. In the univariable analysis, abnormal T2-weighted signal of the left dentate nucleus (DN) (74.5% in the pCMS group vs 36.4% in the non-pCMS group, p < 0.001), right DN (83.0% vs 40.3%, p < 0.001), left superior cerebellar peduncle (SCP) (74.5% vs 27.3%, p < 0.001), right SCP (63.8% vs 23.4%, p < 0.001), left middle cerebellar peduncle (MCP) (51.1% vs 26.0%, p = 0.008), and right MCP (61.7% vs 26.0%, p < 0.001); male sex (83.0% vs 45.5%, p < 0.001); vermis 3 impairment (49.4% vs 19.1%, p = 0.002); solid tumor (91.5% vs 72.7%, p = 0.022); and hydrocephalus (72.3% vs 45.5%, p = 0.006) were more frequent in the pCMS group than in the non-pCMS group. Multivariable logistic analysis showed that male sex (adjusted OR 4.08, p = 0.010) and the cerebro-cerebellar circuit score of T2-weighted images (adjusted OR 2.15, p < 0.001) were independent risk factors for pCMS. The cerebro-cerebellar circuit score positively correlated with the duration of mutism. In Cox regression analysis, the cerebro-cerebellar integrated circuit injury score of T2 (adjusted HR 0.790, 95% CI 0.637-0.980; p = 0.032) and injury of vermis 3 (adjusted HR 3.005, 95% CI 1.197-7.547; p = 0.019) were independently associated with the duration of mutism.
Male sex and cerebro-cerebellar circuit damage are independent risk factors for pCMS. The cerebro-cerebellar circuit score indicates the duration of mutism.
摘要：
目的：在本研究中，作者旨在探讨术后MRI特征与小脑mutism综合征之间的关系。
方法：对2013年7月至2021年3月因中线后颅窝肿瘤而接受肿瘤切除术的患者进行回顾性队列研究。所有患者至少随访一次。从医疗记录和随访数据库中提取临床数据。两名神经放射科医生独立审查了术前和术后的MRI。进行单变量和多变量分析以比较术后小脑mutism综合征（pCMS）和非pCMS组。相关性分析采用Spearman相关系数分析。
结果：在124例患者中，47（37.9%）发展pCMS。中位随访时间为45.73(Q1:33.4,Q3:64.0)个月。mutism的中位持续时间为45天。中位肿瘤大小为48.8(Q1:42.1,Q3:56.8)mm。在单变量分析中，左齿状核(DN)T2加权信号异常(pCMS组74.5%vs非pCMS组36.4%,p<0.001)，右DN（83.0%vs40.3%，p<0.001)，左上小脑花梗（SCP）（74.5%vs27.3%，p<0.001)，右SCP（63.8%vs23.4%，p<0.001)，左中小脑梗（MCP）（51.1%vs26.0%，p=0.008),和右MCP(61.7%对26.0%，p<0.001)；男性(83.0%vs45.5%，p<0.001)；疣3损伤(49.4%对19.1%，p=0.002）；实体瘤（91.5%vs72.7%，p=0.022）；和脑积水（72.3％vs45.5％，p=0.006）在pCMS组中比非pCMS组中更频繁。多因素Logistic分析显示，男性（校正OR4.08，p=0.010）和T2加权图像的脑小脑回路评分（校正OR2.15，p<0.001）是pCMS的独立危险因素。脑小脑回路评分与mutism的持续时间呈正相关。在Cox回归分析中，脑小脑集成电路损伤评分T2(校正HR0.790,95%CI0.637-0.980;p=0.032)和疣3损伤(校正HR3.005,95%CI1.197-7.547;p=0.019)与默症持续时间独立相关.
结论：男性和小脑回路损害是pCMS的独立危险因素。脑-小脑回路评分表明了默症的持续时间。
方法：对2013年7月至2021年3月因中线后颅窝肿瘤而接受肿瘤切除术的患者进行回顾性队列研究。所有患者至少随访一次。从医疗记录和随访数据库中提取临床数据。两名神经放射科医生独立审查了术前和术后的MRI。进行单变量和多变量分析以比较术后小脑mutism综合征（pCMS）和非pCMS组。相关性分析采用Spearman相关系数分析。
结果：在124例患者中，47（37.9%）发展pCMS。中位随访时间为45.73(Q1:33.4,Q3:64.0)个月。mutism的中位持续时间为45天。中位肿瘤大小为48.8(Q1:42.1,Q3:56.8)mm。在单变量分析中，左齿状核(DN)T2加权信号异常(pCMS组74.5%vs非pCMS组36.4%,p<0.001)，右DN（83.0%vs40.3%，p<0.001)，左上小脑花梗（SCP）（74.5%vs27.3%，p<0.001)，右SCP（63.8%vs23.4%，p<0.001)，左中小脑梗（MCP）（51.1%vs26.0%，p=0.008),和右MCP(61.7%对26.0%，p<0.001)；男性(83.0%vs45.5%，p<0.001)；疣3损伤(49.4%对19.1%，p=0.002）；实体瘤（91.5%vs72.7%，p=0.022）；和脑积水（72.3％vs45.5％，p=0.006）在pCMS组中比非pCMS组中更频繁。多因素Logistic分析显示，男性（校正OR4.08，p=0.010）和T2加权图像的脑小脑回路评分（校正OR2.15，p<0.001）是pCMS的独立危险因素。脑小脑回路评分与mutism的持续时间呈正相关。在Cox回归分析中，脑小脑集成电路损伤评分T2(校正HR0.790,95%CI0.637-0.980;p=0.032)和疣3损伤(校正HR3.005,95%CI1.197-7.547;p=0.019)与默症持续时间独立相关.
结论：男性和小脑回路损害是pCMS的独立危险因素。脑-小脑回路评分表明了默症的持续时间。
