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. 2023 Sep 7:4:102671.
doi: 10.1016/j.bas.2023.102671. eCollection 2024.

Radiological characterization of pediatric intramedullary astrocytomas: Do they differ from adults?

Nathalie Gilis  1 , Laetitia Lebrun  2 , Valentina Lolli  3 , Philippe David  3 , Marine Rodesch  4 , Alix Bex  1 , Christophe Fricx  4 , Vivianne De Maertelaer  5 , Isabelle Salmon  2 , Olivier De Witte  1
Affiliations

Radiological characterization of pediatric intramedullary astrocytomas: Do they differ from adults?

Nathalie Gilis et al. Brain Spine. .

Abstract

Introduction: The incidence of intramedullary spinal cord tumors ranges from 2 to 4% of all central nervous system tumors. Only 6-8% are astrocytomas. The gold standard to diagnose a spinal cord tumor is the spinal cord MRI in toto. Specific radiological criteria orient the diagnosis of the intradural intramedullary lesion. Most of the authors studied adult populations of astrocytomas. However, pediatric astrocytomas present certain particularities.

Research question: This work aims to determine if the usual radiological criteria of intramedullary astrocytomas (IMAs) are different depending on the patient's age.

Material & methods: We evaluated the radiological features of IMAs in adult and pediatric groups through a retrospective study.

Results: We collected 31 patients with IMAs (11 children and 20 adults). We observed some trends but we did not highlight any statistically significant difference between all the radiological criteria studied (sagittal and axial spinal cord localization, T1-and T2-weighted characteristics, contrast uptake, infiltrating character, presence of necrosis, heterogeneous lesion, necrotic, hemorrhagic, presence of edema) and the patient's age.

Discussion & conclusion: Given the rarity of IMAs and the lack of large specific pediatric studies, it seems essential to routinely report all cases encountered and create multicentric pediatric databases to draw more robust conclusions.

Keywords: Intramedullary astrocytoma; Pediatric spinal cord tumor; Pilocytic astrocytoma.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
12-year-old girl with a medullary pilocytic astrocytoma. A. Sagittal T2-WI; B. Sagittal post-gadolinium T1-WI; C. Axial post-gadolinium T1-WI; D. Axial T2*-WI). MRI of the spinal cord reveals an intramedullary tumor mass extending from the inferior aspect of C4 to the upper part of Th1. There is expansion of the dural canal and moderate bone scalloping. The lesion shows increased SI on T2- (A) and T2* (D) -WI and marked peripheral enhancement (B, C). There is marked T2 prolongation below and above the tumoral mass indicating vasogenic edema (A) Legend: WI = weighted image; SI = signal intensity.
Fig. 2
Fig. 2
Comparison of pediatric and adult pilocytic astrocytomas. A. and D. Sagittal T2-WI. B. Sagittal T1-WI. C. Sagittal post-gadolinium T1-WI. E. Axial T2-WI. Pediatric case: MRI reveals an intramedullary tumor mass with multiple cysts extending from C2 to C7 without any surrounding edema (A, B). The solid component of the astrocytoma shows contrast enhancement (C). Adult case: MRI demonstrates extensive vasogenic edema surrounding the pilocytic astrocytoma extending from C2 to C7 on sagittal and axial planes (D, E). Legend: WI = weighted image.
See this image and copyright information in PMC

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