The Value of Diffusion Tensor Imaging in Differential Diagnosis of Embryonal Tumors Occurring in the Brainstem and Brainstem Gliomas in Pediatric Patients - 22/01/25

Doi : 10.1016/j.pediatrneurol.2024.11.011

Wenjiao Xiao, MMed ^a, Shuang Li, MMed ^a, Zanyong Tong, MMed ^a, Lusheng Li, MD ^b,^{^{1
These authors have contributed equally to this work and share corresponding authorship.},}^⁎ , Yuting Zhang, MD ^a,^{^{1
These authors have contributed equally to this work and share corresponding authorship.},}^⁎
^a Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
^b Department of Neurosurgery Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China

^∗Communications should be addressed to: Dr. Zhang; Department of Radiology; Children’s Hospital of Chongqing Medical University; No. 20 Jinyu Avenue; Liangjiang District, Chongqing 401122, China.Department of Radiology; Children’s Hospital of Chongqing Medical UniversityNo. 20 Jinyu Avenue; Liangjiang DistrictChongqing401122China^∗∗Communications should be addressed to: Dr. Li; Department of Neurosurgery; Children’s Hospital of Chongqing Medical University; No. 20 Jinyu Avenue; Liangjiang District, Chongqing 401122, China.Department of Neurosurgery; Children’s Hospital of Chongqing Medical UniversityNo. 20 Jinyu Avenue; Liangjiang DistrictChongqing401122China

Abstract

Background

There are no apparent distinctions in clinical presentation or conventional imaging findings between brainstem gliomas and embryonal tumors occurring in the brainstem. Our aim was to study the role of diffusion tensor imaging in differentiating embryonal tumors from gliomas of the brainstem.

Methods

Three cases of embryonal tumors occurring in the brainstem and 19 cases of brainstem gliomas were analyzed retrospectively.

Result

The most common brainstem gliomas are diffuse intrinsic pontine gliomas. On the fiber tracking images, brainstem gliomas were associated with relatively intact projection fibers that continuously traversed the tumor and followed the trajectory of normal neural fibers, whereas embryonal tumors were associated with disruption of projection fibers. The close cellularity created tissues with significant directional properties in embryonal tumors, restricting the diffusion of water molecules. As a result, there were areas of high anisotropy within the embryonal tumors. Additionally, we observed that the apparent diffusion coefficient value of embryonal tumors occurring in the brainstem was lower than that of brainstem gliomas and the difference was statistically significant (P < 0.05).

Conclusion

Disruption of projection fibers within the tumor on diffusion tensor imaging may help differentiate embryonal pathology from glial.

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Keywords : DTI, Fiber tracking, Embryonal tumors, Brainstem gliomas

Plan

Introduction

Patients and methods

Selection of patients

Imaging protocol

Imaging postprocessing

CRediT authorship contribution statement

Ethical approval and informed consent: This study obtained approval from the Ethics Committee of the Children's Hospital of Chongqing Medical University.

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Vol 163

P. 58-65 - février 2025 Retour au numéro

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The Value of Diffusion Tensor Imaging in Differential Diagnosis of Embryonal Tumors Occurring in the Brainstem and Brainstem Gliomas in Pediatric Patients - 22/01/25

Abstract

Background

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Plan

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