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Neuroradiology
Published in: Neuroradiology 6/2015

01-06-2015 | Paediatric Neuroradiology

Differential imaging characteristics and dissemination potential of pilomyxoid astrocytomas versus pilocytic astrocytomas

Authors: Bálint Alkonyi, Johannes Nowak, Astrid K. Gnekow, Torsten Pietsch, Monika Warmuth-Metz

Published in: Neuroradiology | Issue 6/2015

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Abstract

Introduction

Pilomyxoid astrocytoma (PMA) is a rare WHO grade II tumor occurring most often in young children. PMA is associated with worse outcome as compared to the pathologically related pilocytic astrocytoma (PA). The radiological differentiation of PMAs from PAs is challenging. Furthermore, it is not completely clarified whether PMA is associated with a higher rate of cerebrospinal fluid (CSF) dissemination in the youngest pediatric population as compared to PA. The aim of our study was firstly to compare imaging features of these tumors and, secondly, to evaluate the occurrence of CSF dissemination.

Methods

The study population included 15 children with PMA and 32 children with PA. The initial MRI and CT scans from the time of the diagnosis were retrospectively analyzed according to standardized criteria and the findings compared between the two tumor types. Furthermore, we also compared the occurrence of imaging evidences of CSF dissemination.

Results

PMAs showed less frequently cystic components (p = 0.03) and never had large tumor cysts. Gadolinium enhancement of PMAs was more frequently homogeneous (p = 0.006). PMAs appeared to show more often intratumoral hemorrhages (p = 0.047). Within the subgroup of children <6 years of age, the PMA histology tended to have a larger effect on the occurrence of CSF dissemination than the age (p = 0.05 vs. 0.12).

Conclusion

Some imaging features like enhancement pattern or presence of cysts or hemorrhage may help differentiating these low-grade gliomas. Our results confirm previous scarce data suggesting a higher rate of CSF dissemination in PMAs, even in the youngest patient population.
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Metadata
Title
Differential imaging characteristics and dissemination potential of pilomyxoid astrocytomas versus pilocytic astrocytomas
Authors
Bálint Alkonyi
Johannes Nowak
Astrid K. Gnekow
Torsten Pietsch
Monika Warmuth-Metz
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 6/2015
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-015-1498-4

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