Comparative study on imaging characteristics of pilocytic astrocytomas in children and adolescents

This study investigated imaging differences of intracranial pilocytic astrocytomas (PA) between children and adolescents. We retrospectively analyzed imaging data from 19 children and 19 adolescents admitted to People's Hospital of Rizhao between January 2018 and December 2024. The mean age was 5.95±2.82 years in the children group and 21.00±3.61 years in the adolescent group. There were no significant differences in sex, extent of resection, tumor extension, or supratentorial/infratentorial location between the two groups. Tumors were significantly larger in the children group compared with the adolescent group (4.39±1.98 cm vs 3.30±0.88, P=0.035). Tumors at midline location were more prevalent in the children group compared with the adolescent group (84.21% vs 31.58%, P=0.001). Significant between-group differences were observed in morphology of regularity (52.63% vs 10.53%, P=0.005), and obstructive hydrocephalus (36.84% vs 5.26%, P=0.017). However, no significant differences were observed between groups in terms of tumor type, enhancement pattern, morphology, edema, or DWI signal. These imaging features, particularly regarding tumor size, midline location, morphological regularity, and obstructive hydrocephalus, may aid in preoperative diagnosis.