Objective To explore the clinical and pathological features, diagnosis and treatment of eosinophilic cystitis in children. Method The clinical data of 7 patients with eosinophilic cystitis admitted from 2012 to 2016 were retrospectively analyzed, and the related literature were reviewed. Results The median age of the 7 patients was 9 years, and clinical manifestations were urgent urination, frequent micturition, odynuria, hematuria, abdominal pain and nocturnal enuresis. Ultrasonography and CT examination showed thickened bladder wall and space occupying lesions.All the 7 children received bladder biopsy, and pathology was consistent with eosinophilic cystitis. Six of them were cured after 2 months of drug therapy, and the other one was cured by repeated drug treatment for 1 year.All patients were followed up for 3 months to 4 years until the abnormal symptoms of voiding disappeared and the abnormal changes of bladder disappeared by imaging examination. Conclusion Eosinophilic cystitis in children is a benign lesion, having extremely similar clinical manifestations to bladder tumor. Without biopsy, the diagnosis of eosinophilic cystitis can also be made according to the clinical manifestation, laboratory examination and treatment effect. The treatment for this disease mainly includes hormone, antihistamine and anti-inflammatory drugs.

OBJECTIVETo investigate the clinical value of high-field-strength intraoperative magnetic resonance imaging (iMRI) combined with optic radiation neuro-navigation for the resection of temporal lobe low-grade gliomas.

METHODSFrom April 2009 to September 2013, 65 patients with temporal lobe low-grade gliomas (WHO grade II) involving optic radiation were operated with iMRI and functional neuro-navigation. Diffusion tensor imaging (DTI) based fiber tracking was used to delineate optic radiation. The reconstructed optic radiations were integrated into a navigation system, in order to achieve intraoperative microscopic-based functional neuro-navigation. iMRI was used to update the images for both optic radiations and residual tumors. Volumetric analyses were performed using 3D Slicer for pre- and intra-operative tumor volumes in all cases. All patients were evaluated for visual field deficits preoperatively and postoperatively. The Student t test was used to evaluate the average rate of extent of resection between groups. Spearman rank correlation analysis was used to assess correlations between predictors and epilepsy prognosis.

RESULTSPreoperative tumor volumes were (78±40) cm3. In 29 cases, iMRI scan detected residual tumor that could be further resected, and extent of resection were increased from 76.2% to 92.7% (t=7.314, P<0.01). In 19 cases (29.2%), gross total resection was accomplished, and iMRI contributed directly to 8 of these cases. Postsurgical follow-up period varied from 13 months to 59 months, mean (33±13) months. Tumor progression were observed in 3 patients, newly developed or deteriorated visual field defects occurred in 4 patients (6.2%). For patients with pre-operative seizures, Engel Class I were achieved for 89.7% of them. Spearman rank correlation analysis revealed that seizure outcome (Engel Class) was related to increased excision of ratio (r=-0.452, P=0.004, 95% CI: -0.636--0.261) and larger tumors (r=0.391, P=0.014, 95% CI: 0.178-0.484).

CONCLUSIONSWith iMRI and functional neuro-navigation, the optic radiation can be accurately located, while extent of resection can be evaluated intra-operatively. This technique is safe and helpful for preservation of visual field for the resection of temporal lobe low-grade gliomas involving optic radiation.

Brain Neoplasms ; pathology ; surgery ; Glioma ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Neuronavigation ; Temporal Lobe ; surgery