مقاله شماره ۲۱
#Pediatric
#Neurology
#Radiology
عنوان:
MRI Findings in Pediatric Pseudotumor Cerebri Syndrome
سایتیشن:
Kohli et al.
مجله:
Pediatric Neurology
تاریخ انتشار:
17, May, 2019
چکیده:
BACKGROUND
Revised diagnostic criteria for pseudotumor cerebri syndrome require three of four neuroimaging findings in the absence of papilledema. We examined the sensitivity and specificity of three or more of four of these magnetic resonance imaging (MRI) findings for pseudotumor cerebri syndrome in children.
METHODS
As part of clinical care, patients in whom there was suspicion for pseudotumor cerebri syndrome underwent neurological and fundoscopic examinations, lumbar puncture, MRI, or magnetic resonance venogram. For this retrospective study, we used this information to classify 119 subjects into definite (n = 66) or probable pseudotumor cerebri syndrome (n = 12), elevated opening pressure without papilledema (n = 23), or controls who had normal opening pressure without papilledema (n = 24). A neuroradiologist, unaware of the clinical findings or original MRI report, reviewed MRIs for pituitary gland flattening, flattening of the posterior sclera, optic nerve sheath distention, and transverse venous sinus stenosis.
RESULTS
The presence of three or more MRI findings has a sensitivity of 62% (95% confidence interval: 47% to 75%) and a specificity of 95% (95% confidence interval: 77% to 100%), compared with controls. Two of three (transverse venous sinus stenosis, pituitary gland flattening, flattening of the posterior sclera) had a similar sensitivity and specificity. Transverse venous sinus stenosis alone had a slightly higher sensitivity (74%, 95% confidence interval: 60% to 85%) and specificity (100%, 95% confidence interval: 80% to 100%).
CONCLUSIONS
In children, three of four of the proposed neuroimaging criteria and transverse venous sinus stenosis alone have a moderate sensitivity and robust specificity for pseudotumor cerebri syndrome. MRIs should be reviewed for these criteria, and their presence should raise suspicion for pseudotumor cerebri syndrome in children, particularly if the presence of papilledema is uncertain.
DOI: https://dx.doi.org/10.1016/j.pediatrneurol.2019.04.010
توضیحات مهم:
✅ سندرم Pseudotumor cerebri (پرفشاری خون ایدیوپاتیک intracranial) یک اختلال نسبتاً شایع است و اغلب با سردرد و papilledema بروز می کند.
✔️ معیارهای تشخیصی اصلاح شده ای بر اساس neuroimaging از جمله flat شدت غده هیپوفیز و اسکلرا خلفی ، distension غلاف عصب بینایی و تنگی سینوس وریدی عرضی وجود دارد.
✔️ نویسندگان در این مطالعه ، 101 بیمار را که از نظر بالینی مظنون به سندرم Pseudotumor cerebri بودند مورد بررسی قرار دادند و این بیماران را با 24 کنترل مقایسه کردند.
✔️ نتایج این مطالعه نشان داد که وجود سه یا بیشتر یافته در MRI حساسیت ۶۲٪ و اختصاصیت ۹۵٪ برای تشخیص این سندرم دارد.
✔ تنگی سینوس وریدی عرضی به تنهایی از حساسیت (74٪) و اختصاصیت (100٪) بالاتری برخوردار بود.
🔎 @Meditorha
#Pediatric
#Neurology
#Radiology
عنوان:
MRI Findings in Pediatric Pseudotumor Cerebri Syndrome
سایتیشن:
Kohli et al.
مجله:
Pediatric Neurology
تاریخ انتشار:
17, May, 2019
چکیده:
BACKGROUND
Revised diagnostic criteria for pseudotumor cerebri syndrome require three of four neuroimaging findings in the absence of papilledema. We examined the sensitivity and specificity of three or more of four of these magnetic resonance imaging (MRI) findings for pseudotumor cerebri syndrome in children.
METHODS
As part of clinical care, patients in whom there was suspicion for pseudotumor cerebri syndrome underwent neurological and fundoscopic examinations, lumbar puncture, MRI, or magnetic resonance venogram. For this retrospective study, we used this information to classify 119 subjects into definite (n = 66) or probable pseudotumor cerebri syndrome (n = 12), elevated opening pressure without papilledema (n = 23), or controls who had normal opening pressure without papilledema (n = 24). A neuroradiologist, unaware of the clinical findings or original MRI report, reviewed MRIs for pituitary gland flattening, flattening of the posterior sclera, optic nerve sheath distention, and transverse venous sinus stenosis.
RESULTS
The presence of three or more MRI findings has a sensitivity of 62% (95% confidence interval: 47% to 75%) and a specificity of 95% (95% confidence interval: 77% to 100%), compared with controls. Two of three (transverse venous sinus stenosis, pituitary gland flattening, flattening of the posterior sclera) had a similar sensitivity and specificity. Transverse venous sinus stenosis alone had a slightly higher sensitivity (74%, 95% confidence interval: 60% to 85%) and specificity (100%, 95% confidence interval: 80% to 100%).
CONCLUSIONS
In children, three of four of the proposed neuroimaging criteria and transverse venous sinus stenosis alone have a moderate sensitivity and robust specificity for pseudotumor cerebri syndrome. MRIs should be reviewed for these criteria, and their presence should raise suspicion for pseudotumor cerebri syndrome in children, particularly if the presence of papilledema is uncertain.
DOI: https://dx.doi.org/10.1016/j.pediatrneurol.2019.04.010
توضیحات مهم:
✅ سندرم Pseudotumor cerebri (پرفشاری خون ایدیوپاتیک intracranial) یک اختلال نسبتاً شایع است و اغلب با سردرد و papilledema بروز می کند.
✔️ معیارهای تشخیصی اصلاح شده ای بر اساس neuroimaging از جمله flat شدت غده هیپوفیز و اسکلرا خلفی ، distension غلاف عصب بینایی و تنگی سینوس وریدی عرضی وجود دارد.
✔️ نویسندگان در این مطالعه ، 101 بیمار را که از نظر بالینی مظنون به سندرم Pseudotumor cerebri بودند مورد بررسی قرار دادند و این بیماران را با 24 کنترل مقایسه کردند.
✔️ نتایج این مطالعه نشان داد که وجود سه یا بیشتر یافته در MRI حساسیت ۶۲٪ و اختصاصیت ۹۵٪ برای تشخیص این سندرم دارد.
✔ تنگی سینوس وریدی عرضی به تنهایی از حساسیت (74٪) و اختصاصیت (100٪) بالاتری برخوردار بود.
🔎 @Meditorha