BACKGROUND AND OBJECTIVE

Meningiomas represent the most prevalent benign intracranial tumors, comprising 13- 26% of primary intracranial neoplasms. These tumors derive their blood supply from both extracranial and intracranial circulation. Over recent decades, pre-operative embolization (POE) has emerged as a potential adjunctive therapy to surgery, aiming to reduce tumor vascularity. Our study seeks to explore the potential correlation between the extent of devascularization following POE of meningiomas and intraoperative blood loss.

This cross-sectional study involved nine meningioma patients at a tertiary hospital, involving chart review of patients across four years. These patients were referred for POE due to angiographic evidence of a hypervascular mass between January 2018 and January 2022. We collected demographic data, tumor characteristics (including location, size, and vascular supply), and intraoperative variables such as total operative time and blood loss. Statistical analyses aimed to uncover correlations between vascularization degree and various factors.

Our population consists predominantly of females (53.68%), with a mean age of 45.85 ± 13.65 years. Only one mortality was recorded (7.7%). Pre-operative embolization achieved devascularization in the majority (69.2%) of cases, with approximately two-thirds (66.7%) experiencing complete devascularization. Mean total operative time stood at 336.11 ± 301.88 minutes, with a mean post-operative blood loss of 985.56 ± 1013.72 milliliters. Additionally, for those with recorded recovery times, the mean recovery time was 14.32 ± 13.51 hours.

Mortality rates showed no association with sex, devascularization status, or number of feeding vessel zones. Furthermore, the extent of devascularization did not correlate with age, sex, number of feeding vessel zones, postoperative blood loss, total operative time, or recovery time (p >0.05).

In summary, this study represents a significant endeavor to elucidate factors influencing meningioma outcomes following pre-operative embolization. Despite limitations regarding patient numbers, our study offers valuable insights into operative parameters and embolization considerations for future analyses in our tertiary center.

Humans ; Meningioma/surgery* ; Tomography, X-Ray Computed ; Meningeal Neoplasms/surgery*

Background and Objective: Meningiomas represent the most prevalent benign intracranial tumors, comprising 13- 26% of primary intracranial neoplasms. These tumors derive their blood supply from both extracranial and intracranial circulation. Over recent decades, pre-operative embolization (POE) has emerged as a potential adjunctive therapy to surgery, aiming to reduce tumor vascularity. Our study seeks to explore the potential correlation between the extent of devascularization following POE of meningiomas and intraoperative blood loss. Methods: This cross-sectional study involved nine meningioma patients at a tertiary hospital, involving chart review of patients across four years. These patients were referred for POE due to angiographic evidence of a hypervascular mass between January 2018 and January 2022. We collected demographic data, tumor characteristics (including location, size, and vascular supply), and intraoperative variables such as total operative time and blood loss. Statistical analyses aimed to uncover correlations between vascularization degree and various factors. Results: Our population consists predominantly of females (53.68%), with a mean age of 45.85 ± 13.65 years. Only one mortality was recorded (7.7%). Pre-operative embolization achieved devascularization in the majority (69.2%) of cases, with approximately two-thirds (66.7%) experiencing complete devascularization. Mean total operative time stood at 336.11 ± 301.88 minutes, with a mean post-operative blood loss of 985.56 ± 1013.72 milliliters. Additionally, for those with recorded recovery times, the mean recovery time was 14.32 ± 13.51 hours. : Mortality rates showed no association with sex, devascularization status, or number of feeding vessel zones. Furthermore, the extent of devascularization did not correlate with age, sex, number of feeding vessel zones, postoperative blood loss, total operative time, or recovery time (p >0.05). Conclusion In summary, this study represents a significant endeavor to elucidate factors influencing meningioma outcomes following pre-operative embolization. Despite limitations regarding patient numbers, our study offers valuable insights into operative parameters and embolization considerations for future analyses in our tertiary center.
Meningioma ; Radiology, Interventional

Recently, deep learning has achieved impressive results in medical image tasks. However, this method usually requires large-scale annotated data, and medical images are expensive to annotate, so it is a challenge to learn efficiently from the limited annotated data. Currently, the two commonly used methods are transfer learning and self-supervised learning. However, these two methods have been little studied in multimodal medical images, so this study proposes a contrastive learning method for multimodal medical images. The method takes images of different modalities of the same patient as positive samples, which effectively increases the number of positive samples in the training process and helps the model to fully learn the similarities and differences of lesions on images of different modalities, thus improving the model's understanding of medical images and diagnostic accuracy. The commonly used data augmentation methods are not suitable for multimodal images, so this paper proposes a domain adaptive denormalization method to transform the source domain images with the help of statistical information of the target domain. In this study, the method is validated with two different multimodal medical image classification tasks: in the microvascular infiltration recognition task, the method achieves an accuracy of (74.79 ± 0.74)% and an F1 score of (78.37 ± 1.94)%, which are improved as compared with other conventional learning methods; for the brain tumor pathology grading task, the method also achieves significant improvements. The results show that the method achieves good results on multimodal medical images and can provide a reference solution for pre-training multimodal medical images.
Humans ; Algorithms ; Brain/diagnostic imaging* ; Brain Neoplasms/diagnostic imaging* ; Recognition, Psychology

Humans ; Child ; Child, Preschool ; Pinealoma ; Prognosis ; Brain Neoplasms/diagnosis* ; Pineal Gland

Objective: To study the clinicopathological characteristics, and further understand primary central nervous system T-cell lymphoma (PCNSTCL) in children and adolescents. Methods: Five cases of PCNSTCL in children and adolescents were collected from December 2016 to December 2021 at the First Affiliated Hospital of Zhengzhou University. The clinicopathological characteristics, immunophenotypic, and molecular pathologic features were analyzed, and relevant literatures reviewed. Results: There were two male and three female patients with a median age of 14 years (range 11 to 18 years). There were two peripheral T-cell lymphomas, not otherwise specified, two anaplastic large cell lymphoma, ALK-positive and one NK/T cell lymphoma. Pathologically, the tumor cells showed a variable histomorphologic spectrum, including small, medium and large cells with diffuse growth pattern and perivascular accentuation. Immunohistochemistry and in situ hybridization showed CD3 expression in four cases, and CD3 was lost in one case. CD5 expression was lost in four cases and retained in one case. ALK and CD30 were expressed in two cases. One tumor expressed CD56 and Epstein-Barr virus-encoded RNA. All cases showed a cytotoxic phenotype with expression of TIA1 and granzyme B. Three cases had a high Ki-67 index (>50%). T-cell receptor (TCR) gene rearrangement was clonal in two cases. Conclusions: PCNSTCL is rare, especially in children and adolescents. The morphology of PCNSTCL is diverse. Immunohistochemistry and TCR gene rearrangement play important roles in the diagnosis.
Female ; Humans ; Male ; Central Nervous System/pathology* ; Central Nervous System Neoplasms/pathology* ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Lymphoma, T-Cell/pathology* ; Lymphoma, T-Cell, Peripheral/genetics* ; Receptor Protein-Tyrosine Kinases/genetics* ; Receptors, Antigen, T-Cell ; Child ; Adolescent

Humans ; Meningioma/pathology* ; Central Nervous System/pathology* ; Meningeal Neoplasms/pathology* ; World Health Organization ; Central Nervous System Neoplasms/pathology*

Humans ; Child ; Glioma/pathology* ; Brain Neoplasms/pathology* ; Central Nervous System/pathology* ; World Health Organization ; Central Nervous System Neoplasms/pathology* ; Mutation

Humans ; Ependymoma/secondary* ; Brain Neoplasms/pathology* ; Skin Neoplasms ; Melanoma ; Spinal Cord Neoplasms/pathology*

Objective: To examine the application value of 3D Slicer software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions. Methods: A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus. Results: All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment. Conclusion: The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
Male ; Female ; Humans ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Brain Neoplasms/pathology* ; Diffusion Tensor Imaging ; Retrospective Studies ; Robotics ; Biopsy ; Software ; Stereotaxic Techniques