MR imaging findings in children with pseudotumor cerebri and comparison with healthy controls

• Published in: Child's nervous system Vol. 31; no. 3; pp. 373 - 380
• Main Authors: Görkem, Süreyya Burcu, Doğanay, Selim, Canpolat, Mehmet, Koc, Gonca, Dogan, Mehmet S., Per, Hüseyin, Coşkun, Abdülhakim
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2015
• Subjects: Adolescent; Brain - pathology; Child; Child, Preschool; Female; Humans; Image Processing, Computer-Assisted; Infant; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Optic Nerve - pathology; Original Paper; Pseudotumor Cerebri - diagnosis; Pseudotumor Cerebri - drug therapy; Retrospective Studies; ROC Curve; Statistics, Nonparametric; Pseudotumor cerebri; MRI; Children
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-014-2579-0

Objective The aim of this study was to discuss the MR imaging findings of pseudotumor cerebri in children by comparing with healthy controls. Materials and methods Forty-two pseudotumor cerebri patients from hospital records between 2003 and 2011 were retrospectively reviewed. Between 2007 and 2011 25 patients (16 boys, 9 girls) whose brain MR images were on PACS workstation were included. Thirty MR imaging examinations (14 boys, 16 girls) which were interpreted as normal constituted the control group. Two pediatric radiologists reviewed each MRI for optic nerve sheath distension, intraocular protrusion of the optic nerve, posterior globe flattening, horizontal tortuosity of the optic nerve, and decreased pituitary gland size. The sensitivity, specificity, and overall accuracy of the findings on MRI were calculated. Results Optic nerve sheath enlarged in the PTC group (mean value, 4.3 mm) than in the control group (mean value, 3.2 mm). It had 88 % sensitivity and 80 % specificity. Pituitary gland size was decreased in PTC group (mean value, 3.63 mm) than in the control group (mean value, 5.05 mm). It had a sensitivity of 64 % and specificity of 90 %. Posterior globe flattening had 56 % sensitivity and 100 % specificity, intraocular protrusion of the optic nerve had 40 % sensitivity and 100 % specificity, and horizontal tortuosity of the optic nerve had 68 % sensitivity and 83 % specificity. Conclusions According to our study, posterior globe flattening, intraocular protrusion of the optic nerve, horizontal nerve sheath tortuosity, optic nerve sheath distension, and decreased pituitary gland size are reliable neuroradiological diagnostic markers for pediatric pseudotumor cerebri.