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Cerebellar Mutism Syndrome and Dentato-Thalamo-Cortical Tract Disruption in Diffusion Tractography Following Surgery for Medulloblastoma.
Ji, Qing; McAfee, Samuel S; Scoggins, Matthew; Holtrop, Joseph; Glass, John O; Yuan, Xiaomeng; Liang, Jia; Li, Yimei; Chiang, Jason; Orr, Brent A; Edwards, Angela; Storment, Diana; Brinkman, Tara; Robinson, Giles W; Gajjar, Amar; Reddick, Wilburn E; Patay, Zoltán; Khan, Raja B; Bag, Asim K.
Afiliação
  • Ji Q; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • McAfee SS; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Scoggins M; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Holtrop J; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Glass JO; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Yuan X; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Liang J; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Li Y; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Chiang J; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Orr BA; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Edwards A; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Storment D; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Brinkman T; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Robinson GW; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Gajjar A; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Reddick WE; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Patay Z; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Khan RB; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
  • Bag AK; From the Departments of Diagnostic Imaging (Q.J., S.S.M., M.S., J.H., J.O.G., A.E., D.S., W.E.R., Z.P., A.K.B.), Biostatistics (X.Y., J.L., Y.L.), Pathology (J.C., B.A.O.), Epidemiology and Cancer Control (T.B.), Oncology (G.W.R., A.G.), Neurology (R.B.K.), and Pediatric Medicine (R.B.K.), St. Jude
Radiology ; 311(2): e232521, 2024 05.
Article em En | MEDLINE | ID: mdl-38742969
ABSTRACT
Background Cerebellar mutism syndrome (CMS), a complication following medulloblastoma surgery, has been linked to dentato-thalamo-cortical tract (DTCT) injury; the association of the degree of DTCT injury with severity of CMS-related symptoms has not been investigated. Purpose To investigate the association between severity of CMS-related symptoms and degree and patterns of DTCT injury with use of diffusion tensor imaging (DTI), and if laterality of injury influences neurologic symptoms. Materials and Methods This retrospective case-control study used prospectively collected clinical and DTI data on patients with medulloblastoma enrolled in a clinical trial (between July 2016 and February 2020) and healthy controls (between April and November 2017), matched with the age range of the participants with medulloblastoma. CMS was divided into types 1 (CMS1) and 2 (CMS2). Multivariable logistic regression was used to investigate the relationship between CMS likelihood and DTCT injury. Results Overall, 82 participants with medulloblastoma (mean age, 11.0 years ± 5.2 [SD]; 53 male) and 35 healthy controls (mean age, 18.0 years ± 3.06; 18 female) were included. In participants with medulloblastoma, DTCT was absent bilaterally (AB), absent on the right side (AR), absent on the left side (AL), or present bilaterally (PB), while it was PB in all healthy controls. Odds of having CMS were associated with higher degree of DTCT damage (AB, odds ratio = 272.7 [95% CI 269.68, 275.75; P < .001]; AR, odds ratio = 14.40 [95% CI 2.84, 101.48; P < .001]; and AL, odds ratio = 8.55 [95% CI 1.15, 74.14; P < .001). Left (coefficient = -0.07, χ2 = 12.4, P < .001) and right (coefficient = -0.15, χ2 = 33.82, P < .001) DTCT volumes were negatively associated with the odds of CMS. More participants with medulloblastoma with AB showed CMS1; unilateral DTCT absence prevailed in CMS2. Lower DTCT volumes correlated with more severe ataxia. Unilateral DTCT injury caused ipsilateral dysmetria; AB caused symmetric dysmetria. PB indicated better neurologic outcome. Conclusion The severity of CMS-associated mutism, ataxia, and dysmetria was associated with DTCT damage severity. DTCT damage patterns differed between CMS1 and CMS2. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Dorigatti Soldatelli and Ertl-Wagner in this issue.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Neoplasias Cerebelares / Imagem de Tensor de Difusão / Meduloblastoma / Mutismo Limite: Adolescent / Child / Female / Humans / Male Idioma: En Ano de publicação: 2024 Tipo de documento: Article
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Neoplasias Cerebelares / Imagem de Tensor de Difusão / Meduloblastoma / Mutismo Limite: Adolescent / Child / Female / Humans / Male Idioma: En Ano de publicação: 2024 Tipo de documento: Article