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Abstract：
The treatment of central nervous system (CNS) tumors constitutes a significant part of a pediatric neurosurgeon\'s workload. The classification of such neoplasms spans many entities. These include low- and high-grade lesions, with both occurring in the population of patients under 18 years of age. Magnetic resonance imaging serves as the imaging method of choice for neoplastic lesions of the brain. Through its different modalities, such as T1, T2, T1 C+, apparent diffusion coefficient (ADC), diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), fluid-attenuated inversion recovery (FLAIR), etc., it allows the medical team to plan the therapeutic process accordingly while also possibly suggesting the specific tumor subtype prior to obtaining a definitive histological diagnosis. We conducted a retrospective study spanning 32 children treated surgically for brain tumors between July 2021 and January 2023 who had a precise histological diagnosis determined by using the 2021 WHO Classification of Tumors of the Central Nervous System. We divided them into two groups (high-grade and low-grade tumors, i.e., WHO grades 1 and 2, and grades 3 and 4, respectively) and analyzed their demographic data and preoperative MRI results. This was done using the following criteria: sub or supratentorial location of the tumor; lesion is circumscribed or infiltrating; solid, cystic, or mixed solid and cystic character of the tumor; number of compartments in cystic lesions; signal intensity (hypo-, iso-, hyperintensity sequences: T1, T2, T1 C+); presence of restricted diffusion; the largest diameter of the solid component and/or the largest diameter of the largest cyst in the transverse section. Then, we examined the results to find any correlation between the lesions\' morphologies and their final assigned degree of malignancy. We found that the only radiological criteria correlating with the final WHO grade of the tumor were an infiltrative pattern of growth (25% of low-grade lesions, 75% of high-grade; p = 0.006) and the presence of a cystic component in the tumor (in 68.75% of low-grade tumors and 43.75% of high-grade tumors; p = 0.041). The only other feature close to attaining statistical significance was diffusion restriction (33.3% of low-grade tumors, 66.7% high-grade; p = 0.055). Older children tended to present with tumors of lower degrees of malignancy, and there was a predominance of female patients (21 female, 11 male).
摘要：
中枢神经系统（CNS）肿瘤的治疗是小儿神经外科医生工作量的重要组成部分。此类肿瘤的分类跨越许多实体。这些包括低级和高级病变，两者都发生在18岁以下的患者人群中。磁共振成像是脑部肿瘤病变的首选成像方法。通过其不同的方式，例如T1，T2，T1C+，表观扩散系数(ADC)，弥散加权成像(DWI),磁敏感加权成像（SWI），流体衰减反转恢复(FLAIR),等。,它允许医疗团队相应地计划治疗过程，同时也可能在获得明确的组织学诊断之前提出特定的肿瘤亚型。我们对2021年7月至2023年1月间接受手术治疗的32名儿童进行了回顾性研究，这些儿童的精确组织学诊断是通过使用2021年WHO中枢神经系统肿瘤分类确定的。我们将它们分为两组（高级别和低级别肿瘤，即，分别为WHO1级和2级以及3级和4级），并分析了其人口统计学数据和术前MRI结果。这是使用以下标准完成的：肿瘤的幕下或上位置；病变是孤立的或浸润的；实性，囊性的,或肿瘤的混合实性和囊性；囊性病变中的区数；信号强度(低，iso-,高强度序列：T1，T2，T1C）；存在限制扩散；横截面中固体成分的最大直径和/或最大囊肿的最大直径。然后，我们检查了结果,发现病变形态与最终指定的恶性程度之间存在相关性.我们发现，与WHO肿瘤最终分级相关的唯一放射学标准是浸润性生长模式（低度病变的25％，75％的高级别；p=0.006）和肿瘤中存在囊性成分（在68.75％的低级别肿瘤和43.75％的高级别肿瘤中；p=0.041）。唯一接近达到统计学意义的特征是弥散限制（33.3％的低度肿瘤，66.7%的高品位；p=0.055)。年龄较大的儿童倾向于出现较低恶性程度的肿瘤，女性患者占主导地位(21名女性，11男）。
