目的:本研究旨在检测小儿幕下肿瘤患者的幕上皮质和皮质下形态学变化。
方法:本研究纳入了24名年龄在4-18岁之间、被诊断为原发性幕下肿瘤的患者和41名年龄和性别相匹配的健康对照者。使用应用于T2轴图像的深度学习算法生成脑磁共振成像的合成磁化准备的快速梯度回波图像。皮质厚度,表面积,volume,和局部回旋指数(LGI),以及皮质下灰质体积,自动计算。使用一般线性模型比较患者和对照组的基于表面的形态测量参数,使用t检验和Mann-WhitneyU检验比较皮质下结构之间的体积。
结果:在患者组中,皮质变薄是在左半脑膜上观察到的,在左尾中额叶(CMF)观察到皮质增厚,左梭形,左外侧眶额,左舌回,右CMF,右后扣带回,右上额叶(P<0.050)。患者组显示三角部体积减少,paracentral,前中心,和左半球的翼上回(P<0.05)。双侧上额叶和扣带回的表面积减少(P<0.05)。患者组在右侧中央前回和颞上回表现为LGI降低,左半侧,和后扣带回回,显示双侧尾状核和海马体积增加,虽然在双侧壳核观察到体积减少,苍白球,杏仁核(P<0.05)。在双侧CMF中,心室体积和肿瘤体积与皮质厚度呈正相关,而与LGI降低的区域呈负相关(P<0.05)。
结论:后颅窝肿瘤导致皮质结构广泛的形态学改变,最突出的模式是伪善。
结论:本研究阐明了儿童幕下肿瘤对神经系统的影响。为未来旨在减轻这些不利的皮质和皮质下变化并改善患者预后的治疗策略奠定基础。
This study aimed to detect supratentorial cortical and subcortical morphological changes in pediatric patients with infratentorial tumors.
The study included 24 patients aged 4-18 years who were diagnosed with primary infratentorial tumors and 41 age- and gender-matched healthy controls. Synthetic magnetization-prepared rapid gradient echo images of brain magnetic resonance imaging were generated using deep learning algorithms applied to T2-axial images. The cortical thickness, surface area, volume, and local gyrification index (LGI), as well as subcortical gray matter volumes, were automatically calculated. Surface-based morphometry parameters for the patient and control groups were compared using the general linear model, and volumes between subcortical structures were compared using the t-test and Mann-Whitney U test.
In the patient group, cortical thinning was observed in the left supramarginal, and cortical thickening was observed in the left caudal middle frontal (CMF), left fusiform, left lateral orbitofrontal, left lingual gyrus, right CMF, right posterior cingulate, and right superior frontal (P < 0.050). The patient group showed a volume reduction in the pars triangularis, paracentral, precentral, and supramarginal gyri of the left hemisphere (P < 0.05). A decreased surface area was observed in the bilateral superior frontal and cingulate gyri (P < 0.05). The patient group exhibited a decreased LGI in the right precentral and superior temporal gyri, left supramarginal, and posterior cingulate gyri and showed an increased volume in the bilateral caudate nucleus and hippocampus, while a volume reduction was observed in the bilateral putamen, pallidum, and amygdala (P < 0.05). The ventricular volume and tumor volume showed a positive correlation with the cortical thickness in the bilateral CMF while demonstrating a negative correlation with areas exhibiting a decreased LGI (P < 0.05).
Posterior fossa tumors lead to widespread morphological changes in cortical structures, with the most prominent pattern being hypogyria.
This study illuminates the neurological impacts of infratentorial tumors in children, providing a foundation for future therapeutic strategies aimed at mitigating these adverse cortical and subcortical changes and improving patient outcomes.