PDF(Pubmed)
Abstract：
BACKGROUND: Most myelomeningocele (MMC) cases present with ventriculomegaly or hydrocephalus, yet a comprehensive volumetric assessment of MMC intracranial structures is lacking. This study aimed to provide baseline data on intracranial structural volumes immediately after birth in MMC infants who underwent repair surgeries after birth (postnatal repair).
METHODS: In this retrospective single-center study, we analyzed 52 MMC infants undergoing postnatal repair, utilizing head computed tomography scans at birth for volumetric assessment. Intracranial volume (ICV), lateral ventricles volume (LVV), choroid plexus volume (CPV), and posterior cranial fossa volume (PCFV) were measured. Hydrocephalus was classified into no hydrocephalus, progressive hydrocephalus, and hydrocephalus at birth. Comparative analysis employed the Wilcoxon rank-sum test. Receiver operating characteristic (ROC) analysis discriminated cases with and without ventriculoperitoneal shunt (VPS).
RESULTS: The median values were 407.50 mL for ICV, 33.18 mL for LVV, 0.67 mL for CPV, and 21.35 mL for PCFV. Thirty-seven cases (71.15%) underwent VPS. ROC analysis revealed an LVV cut-off value of 6.74 mL for discriminating cases with and without VPS. Progressive hydrocephalus showed no significant difference in ICV but significantly larger LVV compared to no hydrocephalus. Hydrocephalus at birth demonstrated statistically larger ICV and LVV compared to the other two types.
CONCLUSIONS: Baseline volumetric data were provided, and volumetric analysis exhibited statistical differences among three hydrocephalus types. These findings enhance our understanding of intracranial volumetric changes in MMC, facilitating more objective assessments of MMC cases.
METHODS: In this retrospective single-center study, we analyzed 52 MMC infants undergoing postnatal repair, utilizing head computed tomography scans at birth for volumetric assessment. Intracranial volume (ICV), lateral ventricles volume (LVV), choroid plexus volume (CPV), and posterior cranial fossa volume (PCFV) were measured. Hydrocephalus was classified into no hydrocephalus, progressive hydrocephalus, and hydrocephalus at birth. Comparative analysis employed the Wilcoxon rank-sum test. Receiver operating characteristic (ROC) analysis discriminated cases with and without ventriculoperitoneal shunt (VPS).
RESULTS: The median values were 407.50 mL for ICV, 33.18 mL for LVV, 0.67 mL for CPV, and 21.35 mL for PCFV. Thirty-seven cases (71.15%) underwent VPS. ROC analysis revealed an LVV cut-off value of 6.74 mL for discriminating cases with and without VPS. Progressive hydrocephalus showed no significant difference in ICV but significantly larger LVV compared to no hydrocephalus. Hydrocephalus at birth demonstrated statistically larger ICV and LVV compared to the other two types.
CONCLUSIONS: Baseline volumetric data were provided, and volumetric analysis exhibited statistical differences among three hydrocephalus types. These findings enhance our understanding of intracranial volumetric changes in MMC, facilitating more objective assessments of MMC cases.
摘要：
背景：大多数脊髓膜膨出（MMC）病例表现为脑室肥大或脑积水，然而缺乏对MMC颅内结构的全面体积评估.这项研究旨在提供出生后接受修复手术（产后修复）的MMC婴儿出生后立即颅内结构体积的基线数据。
方法：在这项回顾性单中心研究中，我们分析了52名接受产后修复的MMC婴儿，利用出生时的头部计算机断层扫描进行体积评估。颅内容积(ICV),侧脑室容积(LVV),脉络丛容积(CPV),测量后颅窝容积（PCFV）。脑积水分为无脑积水,进行性脑积水,和出生时的脑积水。比较分析采用Wilcoxon秩和检验。接收器工作特征（ROC）分析可区分有和没有脑室腹腔分流术（VPS）的病例。
结果：ICV的中值为407.50mL，用于LVV的33.18mL,CPV为0.67mL，PCFV为21.35mL。37例（71.15%）行VPS。ROC分析显示，区分有和没有VPS的病例的LVV截止值为6.74mL。进行性脑积水在ICV中没有显着差异，但与无脑积水相比，LVV明显更大。与其他两种类型相比，出生时的脑积水显示出统计学上较大的ICV和LVV。
结论：提供了基线体积数据，和体积分析显示三种脑积水类型之间存在统计学差异。这些发现增强了我们对MMC颅内体积变化的理解，有助于更客观地评估MMC病例。
方法：在这项回顾性单中心研究中，我们分析了52名接受产后修复的MMC婴儿，利用出生时的头部计算机断层扫描进行体积评估。颅内容积(ICV),侧脑室容积(LVV),脉络丛容积(CPV),测量后颅窝容积（PCFV）。脑积水分为无脑积水,进行性脑积水,和出生时的脑积水。比较分析采用Wilcoxon秩和检验。接收器工作特征（ROC）分析可区分有和没有脑室腹腔分流术（VPS）的病例。
结果：ICV的中值为407.50mL，用于LVV的33.18mL,CPV为0.67mL，PCFV为21.35mL。37例（71.15%）行VPS。ROC分析显示，区分有和没有VPS的病例的LVV截止值为6.74mL。进行性脑积水在ICV中没有显着差异，但与无脑积水相比，LVV明显更大。与其他两种类型相比，出生时的脑积水显示出统计学上较大的ICV和LVV。
结论：提供了基线体积数据，和体积分析显示三种脑积水类型之间存在统计学差异。这些发现增强了我们对MMC颅内体积变化的理解，有助于更客观地评估MMC病例。
