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

Süreyya Burcu Görkem1, Selim Doğanay, Mehmet Canpolat

  • 1Department of Pediatric Radiology, Erciyes University School of Medicine, Kayseri, Turkey, drburcugorkem@gmail.com.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|November 1, 2014
PubMed

Insights

Magnetic Resonance Imaging (MRI) can identify key indicators of pediatric pseudotumor cerebri (PTC). These include optic nerve sheath distension, globe flattening, and pituitary gland size changes, aiding diagnosis.

Area of Science:

  • Neuroradiology
  • Pediatric Imaging
  • Ophthalmology

Background:

  • Pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension, is a condition characterized by increased intracranial pressure without a clear cause.
  • Accurate diagnosis in children is crucial for timely intervention and preventing vision loss.

Purpose of the Study:

  • To evaluate the diagnostic utility of specific Magnetic Resonance Imaging (MRI) findings in pediatric patients with pseudotumor cerebri (PTC).
  • To compare MRI findings in children with PTC to those in a healthy control group.

Main Methods:

  • Retrospective review of MRI scans from 25 pediatric patients diagnosed with PTC and 30 age-matched healthy controls.
  • Assessment of specific imaging features: optic nerve sheath distension, intraocular optic nerve protrusion, posterior globe flattening, optic nerve tortuosity, and pituitary gland size.
  • Calculation of sensitivity, specificity, and overall accuracy for each identified MRI finding.

Main Results:

  • Significant differences were observed in optic nerve sheath diameter (enlarged in PTC group) and pituitary gland size (decreased in PTC group) compared to controls.
  • Posterior globe flattening (100% specificity) and intraocular optic nerve protrusion (100% specificity) were highly specific indicators.
  • Optic nerve sheath distension (88% sensitivity) and horizontal nerve tortuosity (68% sensitivity) also showed diagnostic value.

Conclusions:

  • Specific MRI findings, including optic nerve sheath distension, posterior globe flattening, intraocular optic nerve protrusion, optic nerve tortuosity, and decreased pituitary gland size, are reliable neuroradiological markers for diagnosing pediatric PTC.
  • These findings can aid in the early and accurate diagnosis of pseudotumor cerebri in children.
Abstract

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