Öz
Objective:
To evaluate the MR imaging findings of the cerebellar tumors (CT) in adults and
to make an algorithm to discriminate these tumors from each other.
Materials
and Methods: Adult patients with CT who were
treated surgically were included. Brain MRs and patient records were evaluated
for pathological diagnosis, imaging findings and Ki-67 labeling index. The
apparent diffusion coefficient (ADC) values of the tumors and centrum semiovale
(CS) and the ratio of each other were noted. Kruskal-Wallis test was used for
comparison.
Results:
100 adults (45 women, 55 men with a mean age of 46.6±15.6
years) with pathologically proven CT were included. Tumors were divided into five
groups as: a. primitive neuro-ectodermal tumor (PNET) + medulloblastoma (MB), b. grade 3+4 gliomas, c. grade 1+2 gliomas, d.
metastasis (MET) and e. lymphoma. The ratio of the mean ADC (x10-3
mm2/s) of the tumor to those of CS was 1.21±0.22, 1.38±0.93, 1.98±0.69, 1.48±0.45 and 1.25±0.11 for PNET&MBs, grade 3+4 gliomas,
grade 1+2 gliomas, METs and lymphomas, respectively. Significant difference was
detected between grade 1+2 gliomas and PNET&MB (P=0.018), MET (P=0.004) and
lymphoma (P=0.002).
Conclusion:
CT in adults might be differentiated from each other by using some
MR imaging clues and patient characteristics.
Anahtar Kelimeler
Kaynakça
- Burger PC, Scheithauer BW. Tumors of the Central Nervous System (Afip Atlas of Tumor Pathology) 1 st ed. Washington; 2007.
- Norden AD, Wen PY, Kesari S. Brain metastases. Curr Opin Neurol 2005;18:654-661.
- Sharma V, Prabhash K, Noronha V, Tandon N, Joshi A. A systematic approach to diagnosis of cystic brain lesions. South Asian J Cancer 2013;2:98-101.
- Rumboldt Z, Camacho DL, Lake D, Welsh CT, Castillo M. Apparent diffusion coefficients for differentiation of cerebellar tumors in children. AJNR Am J Neuroradiol 2006;27:1362-1369.
- Provenzale JM, Mukundan S, Barboriak DP. Diffusion-weighted and perfusion MR imaging for brain tumor characterization and assessment of treatment response. Radiology 2006;239:632-649.
- Ghods AJ, Munoz L, Byrne R. Surgical treatment of cerebellar metastases. Surg Neurol Int 2011;2:159.
- Koeller KK, Rushing EJ. From the archives of the AFIP: pilocytic astrocytoma: radiologic-pathologic correlation. Radiographics 2004;24:1693-1708.
- Johnson DR, Brown PD, Galanis E, Hammack JE. Pilocytic astrocytoma survival in adults: analysis of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. J Neurooncol. 2012;108:187-193.
- Bonneville F, Sarrazin JL, Marsot-Dupuch K, Iffenecker C, Cordoliani YS, Doyon D, et al. Unusual lesions of the cerebellopontine angle: a segmental approach. Radiographics 2001;21:419-438.
- Slater A, Moore NR, Huson SM. The natural history of cerebellar hemangioblastomas in von Hippel-Lindau disease. AJNR Am J Neuroradiol 2003;24:1570-1574.
- Ho VB, Smirniotopoulos JG, Murphy FM, Rushing EJ. Radiologic-pathologic correlation: hemangioblastoma. AJNR Am J Neuroradiol 1992;13:1343-1352.
- Kulkarni AV, Becker LE, Jay V, Armstrong DC, Drake JM. Primary cerebellar glioblastomas multiforme in children. Report of four cases. J Neurosurg 1999;90:546-550.
- Demir MK, Hakan T, Akinci O, Berkman Z. Primary cerebellar glioblastoma multiforme. Diagn Intervent Radiol 2005;11:83-86.
- Gopalakrishnan CV, Dhakoji A, Nair S, Menon G, Neelima R. A retrospective study of primary cerebellar glioblastoma multiforme in adults. J Clin Neurosci 2012;19(12):1684-1688.
- Katz DS, Poe LB, Winfield JA, Corona RJ, Jr. A rare case of cerebellar glioblastoma multiforme in childhood: MR imaging. Clin Imaging 1995;19:162-164.
- Kuroiwa T, Numaguchi Y, Rothman MI, Zoarski GH, Morikawa M, Zagardo MT, et al. Posterior fossa glioblastoma multiforme: MR findings. AJNR Am J Neuroradiol 1995;16:583-589.
- Partap S, Curran EK, Propp JM, Le GM, Sainani KL, Fisher PG. Medulloblastoma incidence has not changed over time: a CBTRUS study. J Pediatr Hematol Oncol 2009;31:970-971.
- Rodallec M, Colombat M, Krainik A, Kalamarides M, Redondo A, Feydy A. Diffusion-weighted MR imaging and pathologic findings in adult cerebellar medulloblastoma. J Neuroradiol 2004;31:234-237.
- Koeller KK, Rushing EJ. From the archives of the AFIP: medulloblastoma: a comprehensive review with radiologic-pathologic correlation. Radiographics 2003;23:1613-1637.
- Koeller KK, Sandberg GD, Armed Forces Institute of P. From the archives of the AFIP. Cerebral intraventricular neoplasms: radiologic-pathologic correlation. Radiographics 2002;22:1473-1505.
- Prince MR, Chew FS. Ependymoma of the fourth ventricle. AJR Am J Roentgenol 1991;157:1278.
- Sanai N, Chang S, Berger MS. Low-grade gliomas in adults. J Neurosurg 2011;115:948-965.
- Kozak KR, Mahadevan A, Moody JS. Adult gliosarcoma: epidemiology, natural history, and factors associated with outcome. Neuro Oncol 2009;11:183-191.
- Pakos EE, Goussia AC, Zina VP, Pitouli EJ, Tsekeris PG. Multi-focal gliosarcoma: a case report and review of the literature. J Neuro Oncol 2005;74:301-304.
- Meltzer CC, Smirniotopoulos JG, Jones RV. The striated cerebellum: an MR imaging sign in Lhermitte-Duclos disease (dysplastic gangliocytoma). Radiology 1995;194:699-703.
- Kulkantrakorn K, Awwad EE, Levy B, Selhorst JB, Cole HO, Leake D, et al. MRI in Lhermitte-Duclos disease. Neurology 1997;48:725-731.
- Wei G, Zhang W, Li Q, Kang X, Zhao H, Liu X, et al. Magnetic resonance characteristics of adult-onset Lhermitte-Duclos disease: An indicator for active cancer surveillance? Mol Clin Oncol 2014;2:415-420.
- Kiewe P, Loddenkemper C, Anagnostopoulos I, Reinwald M, Thiel E, Korfel A. High-dose methotrexate is beneficial in parenchymal brain masses of uncertain origin suspicious for primary CNS lymphoma. Neuro Oncol 2007;9:96-102.
- Ayuso-Peralta L, Orti-Pareja M, Zurdo-Hernandez M, Jimenez-Jimenez FJ, Tejeiro-Martinez J, Ricoy JR, et al. Cerebral lymphoma presenting as a leukoencephalopathy. J Neurol Neurosurg Psychiatry 2001;71:243-246.
Öz
Amaç:
Erişkinlerde serebellar tümörlerin (ST) MR görüntüleme bulgularını inceleyip
birbirlerinden ayrım için algoritmik yaklaşım oluşturabilmek.
Gereç
ve Yöntemler: Çalışmaya, cerrahi olarak tedavi edilmiş ST’li erişkin hastalar
dahil edildi. Beyin MR’ları ve hasta kayıtları
patolojik tanı, görüntüleme bulguları ve Ki-67 indeksi açısından tarandı. Tümöre
ve sentrum semiovale (SS)’ye ait görünür difüzyon katsayıları (GDK) ile
birbirlerine oranları hesaplandı. Karşılaştırma için Kruskal-Wallis testi
kullanıldı.
Bulgular:
Çalışmaya yaş ortalaması 46.6±15.6 yıl olan 100 (45 kadın, 55 erkek) ST’li hasta dahil edildi.
Tümörler 5 gruba ayrıldı: a. primitif nöroektodermal tumor
(PNET)+medulloblastom (MB) b. evre 3+4 gliomlar, c.
evre 1+2 gliomlar, d. metastaz (MET) ve e. lenfoma. PNET&MB, evre 3+4
gliomlar, evre1+2 gliomlar, MET and lenfomalara ait ortalama ST/SS GDK (x10-3
mm2/s) değerleri sıraıyla1.21±0.22, 1.38±0.93, 1.98±0.69, 1.48±0.45 and 1.25±0.11. Evre 1+2 gliomlar ve PNET&MB’ler (P=0.018), MET (P=0.004) ve lenfomalar (P=0.002)
arasında anlamlı fark vardı.
Sonuç:
Erişkinde ST’ler bazı MR ipuçları ve hasta özellikleri ile birbirlerinden ayırt
edilebilir.
Anahtar Kelimeler
Kaynakça
- Burger PC, Scheithauer BW. Tumors of the Central Nervous System (Afip Atlas of Tumor Pathology) 1 st ed. Washington; 2007.
- Norden AD, Wen PY, Kesari S. Brain metastases. Curr Opin Neurol 2005;18:654-661.
- Sharma V, Prabhash K, Noronha V, Tandon N, Joshi A. A systematic approach to diagnosis of cystic brain lesions. South Asian J Cancer 2013;2:98-101.
- Rumboldt Z, Camacho DL, Lake D, Welsh CT, Castillo M. Apparent diffusion coefficients for differentiation of cerebellar tumors in children. AJNR Am J Neuroradiol 2006;27:1362-1369.
- Provenzale JM, Mukundan S, Barboriak DP. Diffusion-weighted and perfusion MR imaging for brain tumor characterization and assessment of treatment response. Radiology 2006;239:632-649.
- Ghods AJ, Munoz L, Byrne R. Surgical treatment of cerebellar metastases. Surg Neurol Int 2011;2:159.
- Koeller KK, Rushing EJ. From the archives of the AFIP: pilocytic astrocytoma: radiologic-pathologic correlation. Radiographics 2004;24:1693-1708.
- Johnson DR, Brown PD, Galanis E, Hammack JE. Pilocytic astrocytoma survival in adults: analysis of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. J Neurooncol. 2012;108:187-193.
- Bonneville F, Sarrazin JL, Marsot-Dupuch K, Iffenecker C, Cordoliani YS, Doyon D, et al. Unusual lesions of the cerebellopontine angle: a segmental approach. Radiographics 2001;21:419-438.
- Slater A, Moore NR, Huson SM. The natural history of cerebellar hemangioblastomas in von Hippel-Lindau disease. AJNR Am J Neuroradiol 2003;24:1570-1574.
- Ho VB, Smirniotopoulos JG, Murphy FM, Rushing EJ. Radiologic-pathologic correlation: hemangioblastoma. AJNR Am J Neuroradiol 1992;13:1343-1352.
- Kulkarni AV, Becker LE, Jay V, Armstrong DC, Drake JM. Primary cerebellar glioblastomas multiforme in children. Report of four cases. J Neurosurg 1999;90:546-550.
- Demir MK, Hakan T, Akinci O, Berkman Z. Primary cerebellar glioblastoma multiforme. Diagn Intervent Radiol 2005;11:83-86.
- Gopalakrishnan CV, Dhakoji A, Nair S, Menon G, Neelima R. A retrospective study of primary cerebellar glioblastoma multiforme in adults. J Clin Neurosci 2012;19(12):1684-1688.
- Katz DS, Poe LB, Winfield JA, Corona RJ, Jr. A rare case of cerebellar glioblastoma multiforme in childhood: MR imaging. Clin Imaging 1995;19:162-164.
- Kuroiwa T, Numaguchi Y, Rothman MI, Zoarski GH, Morikawa M, Zagardo MT, et al. Posterior fossa glioblastoma multiforme: MR findings. AJNR Am J Neuroradiol 1995;16:583-589.
- Partap S, Curran EK, Propp JM, Le GM, Sainani KL, Fisher PG. Medulloblastoma incidence has not changed over time: a CBTRUS study. J Pediatr Hematol Oncol 2009;31:970-971.
- Rodallec M, Colombat M, Krainik A, Kalamarides M, Redondo A, Feydy A. Diffusion-weighted MR imaging and pathologic findings in adult cerebellar medulloblastoma. J Neuroradiol 2004;31:234-237.
- Koeller KK, Rushing EJ. From the archives of the AFIP: medulloblastoma: a comprehensive review with radiologic-pathologic correlation. Radiographics 2003;23:1613-1637.
- Koeller KK, Sandberg GD, Armed Forces Institute of P. From the archives of the AFIP. Cerebral intraventricular neoplasms: radiologic-pathologic correlation. Radiographics 2002;22:1473-1505.
- Prince MR, Chew FS. Ependymoma of the fourth ventricle. AJR Am J Roentgenol 1991;157:1278.
- Sanai N, Chang S, Berger MS. Low-grade gliomas in adults. J Neurosurg 2011;115:948-965.
- Kozak KR, Mahadevan A, Moody JS. Adult gliosarcoma: epidemiology, natural history, and factors associated with outcome. Neuro Oncol 2009;11:183-191.
- Pakos EE, Goussia AC, Zina VP, Pitouli EJ, Tsekeris PG. Multi-focal gliosarcoma: a case report and review of the literature. J Neuro Oncol 2005;74:301-304.
- Meltzer CC, Smirniotopoulos JG, Jones RV. The striated cerebellum: an MR imaging sign in Lhermitte-Duclos disease (dysplastic gangliocytoma). Radiology 1995;194:699-703.
- Kulkantrakorn K, Awwad EE, Levy B, Selhorst JB, Cole HO, Leake D, et al. MRI in Lhermitte-Duclos disease. Neurology 1997;48:725-731.
- Wei G, Zhang W, Li Q, Kang X, Zhao H, Liu X, et al. Magnetic resonance characteristics of adult-onset Lhermitte-Duclos disease: An indicator for active cancer surveillance? Mol Clin Oncol 2014;2:415-420.
- Kiewe P, Loddenkemper C, Anagnostopoulos I, Reinwald M, Thiel E, Korfel A. High-dose methotrexate is beneficial in parenchymal brain masses of uncertain origin suspicious for primary CNS lymphoma. Neuro Oncol 2007;9:96-102.
- Ayuso-Peralta L, Orti-Pareja M, Zurdo-Hernandez M, Jimenez-Jimenez FJ, Tejeiro-Martinez J, Ricoy JR, et al. Cerebral lymphoma presenting as a leukoencephalopathy. J Neurol Neurosurg Psychiatry 2001;71:243-246.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Haziran 2019 |
| Gönderilme Tarihi | 22 Ekim 2018 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 9 Sayı: 2 |
SMJ'de yayınlanan makaleler, Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı kapsamında lisanslanır