المؤلفون: Mufti, N., Chappell, J., Aertsen, M., Ebner, M., Fidon, L., Deprest, J., David, A. L., Melbourne, A., Atkinson, David, Bredaki, Foteini Emmanouella, De Catte, Luc, De Vloo, Phillippe, Demaerel, Philippe, Devlieger, Roland, Gaunt, Trevor, Kendall, Giles S., Ourselin, Sebastien, Baruteau, Kelly Pegoretti, Sacco, Adalina, Sokolska, Magdalena, Thompson, Dominic, Vercauteren, Tom

المصدر: Mufti , N , Chappell , J , Aertsen , M , Ebner , M , Fidon , L , Deprest , J , David , A L , Melbourne , A , Atkinson , D , Bredaki , F E , De Catte , L , De Vloo , P , Demaerel , P , Devlieger , R , Gaunt , T , Kendall , G S , Ourselin , S , Baruteau , K P , Sacco , A , Sokolska , M & Thompson , D & Vercauteren , T 2023 , ' Assessment of longitudinal ....

مصطلحات موضوعية: curvedness, fetal surgery, gyrification, magnetic resonance imaging, MRI, open spina bifida, super-resolution reconstruction, surface area, volume

الوصف: Objectives: Prenatal surgery is offered for selected fetuses with open spina bifida (OSB) to improve long-term outcome. We studied the effect of fetal OSB surgery on brain development using advanced magnetic resonance imaging (MRI) techniques to quantify the volume, surface area and shape of cerebral structures and to analyze surface curvature by means of parameters that correspond to gyrification. Methods: We compared MRI data from 29 fetuses with OSB before fetal surgery (mean gestational age (GA), 23 + 3 weeks) and at 1 and 6 weeks after surgery, with that of 36 GA-matched control fetuses (GA range, 21 + 2 to 36 + 2 weeks). Automated super-resolution reconstruction provided three-dimensional isotropic volumetric brain images. Unmyelinated white matter, cerebellum and ventricles were segmented automatically and refined manually, after which volume, surface area and shape parameter (volume/surface area) were quantified. Mathematical markers (shape index (SI) and curvedness) were used to measure gyrification. Parameters were assessed according to lesion type (myelomeningocele vs myeloschisis (MS)), postoperative persistence of hindbrain herniation (HH) and the presence of supratentorial anomalies, namely partial agenesis of the corpus callosum (pACC) and heterotopia (HT). Results: Growth in ventricular volume per week and change in shape parameter per week were higher at 6 weeks after surgery in fetuses with OSB compared with controls (median, 2500.94 (interquartile range (IQR), 1689.70–3580.80) mm 3 /week vs 708.21 (IQR, 474.50–925.00) mm 3 /week; P < 0.001 and 0.075 (IQR, 0.047–0.112) mm/week vs 0.022 (IQR, 0.009–0.042) mm/week; P = 0.046, respectively). Ventricular volume growth increased 6 weeks after surgery in cases with pACC (P < 0.001) and those with persistent HH (P = 0.002). During that time period, the change in unmyelinated white-matter shape parameter per week was decreased in OSB fetuses compared with controls (0.056 (IQR, 0.044–0.092) mm/week vs 0.159 (IQR, 0.100–0.247) mm/week; P = 0.002), ...

الإتاحة: https://doi.org/10.1002/uog.26244Test
https://kclpure.kcl.ac.uk/portal/en/publications/6207ca0a-738c-4d24-ac06-fd73de83d248Test
http://www.scopus.com/inward/record.url?scp=85175842709&partnerID=8YFLogxKTest

المؤلفون: Wright, Jenny, Cheung, Moira, Siddiqui, Ata, Lucas, Jonathan, Calder, Alistair, Argyropoulou, Maria I., Arthurs, Owen J., Caro-Dominguez, Pablo, Thompson, Dominic, Severino, Mariasavina, D'Arco, Felice, Rossi, Andrea, Adamsbaum, Catherine, Xydis, Vasileios, Connolly, Daniel, Lequin, Maarten Hans, Dangouloff-Ros, Volodia, Porto, Luciana, Piccirilli, Eleonora, Chateil, Jean-François

المصدر: Pediatric Radiology; Nov2023, Vol. 53 Issue 12, p2323-2344, 22p

مصطلحات موضوعية: PEDIATRIC radiology, ACHONDROPLASIA, SPINAL stenosis, NEURORADIOLOGY, SPINE abnormalities

مستخلص: Children living with achondroplasia are at an increased risk of developing neurological complications, which may be associated with acute and life-altering events. To remediate this risk, the timely acquisition of effective neuroimaging that can help to guide clinical management is essential. We propose imaging protocols and follow-up strategies for evaluating the neuroanatomy of these children and to effectively identify potential neurological complications, including compression at the cervicomedullary junction secondary to foramen magnum stenosis, spinal deformity and spinal canal stenosis. When compiling these recommendations, emphasis has been placed on reducing scan times and avoiding unnecessary radiation exposure. Standardized imaging protocols are important to ensure that clinically useful neuroimaging is performed in children living with achondroplasia and to ensure reproducibility in future clinical trials. The members of the European Society of Pediatric Radiology (ESPR) Neuroradiology Taskforce and European Society of Neuroradiology pediatric subcommittee, together with clinicians and surgeons with specific expertise in achondroplasia, wrote this opinion paper. The research committee of the ESPR also endorsed the final draft. The rationale for these recommendations is based on currently available literature, supplemented by best practice opinion from radiologists and clinicians with subject-specific expertise. [ABSTRACT FROM AUTHOR]

: Copyright of Pediatric Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Layard Horsfall, Hugo, Chari, Aswin, Huttunen, Terhi, Simcock, Clare, D'Arco, Felice, Thompson, Dominic

مصطلحات موضوعية: Lumbosacral lipoma, Magnetic resonance imaging, Paediatric neurosurgery, Spinal dysraphism, Child, Preschool, Female, Humans, Infant, Lipoma, Lumbosacral Region, Male, Prospective Studies, Retrospective Studies, Spinal Neoplasms

الوصف: Funder: Great Ormond Street Hospital Charity; doi: http://dx.doi.org/10.13039/501100001279Test ; PURPOSE: Lumbosacral lipoma (LSL) is a severe occult spinal dysraphism, frequently associated with neurological, urological and orthopaedic complications. Whole spine imaging is typically performed to identify concomitant, but spatially separate, congenital anomalies. Our hypothesis: the incidence of additional, clinically significant abnormalities of the neuraxis is low; thus, imaging should be optimised at the lumbosacral region. We aim to assess the prevalence and relevance of LSL-associated lesions. METHOD: A single-centre, retrospective, radiological review using a prospectively maintained operative database. INCLUSION CRITERIA: children (< 16 years) with confirmed diagnosis of LSL and received whole spine MRI. Fatty filum, syndromic cases and cutaneous stigmata above lesion level were excluded. Data was extracted from radiological imaging, reports and clinical correspondence. RESULTS: One hundred twelve patients (40:72, M:F) aged 0.5 years (0.2-2.7) (median ± IQR) with LSL had whole spine MRI between 2001 and 2017. Classification of LSL: transitional 48 (43%); dorsal 30 (27%); caudal 28 (25%) and chaotic 6 (5%). Additional anomalies included syringohydromyelia 44 (39%), subcutaneous tract 19 (17%), abnormal vertebral segmentation 18 (16%), dermoid cyst 1 and 1 Chiari I deformity. There were no Chiari II malformations. No child required surgery for an associated lesion. Binary logistic regression revealed no factors associated with predicting secondary lesions. CONCLUSIONS: In congenital LSL, additional anomalies of the neuraxis are typically loco-regional rather than pan-CNS and additional lesions are rarely clinically significant. The loco-regional distribution of anomalies suggests that only lumbosacral spinal imaging is required in the initial evaluation of LSL. Such a policy would lessen the anaesthetic/sedation time for children and reduce imaging cost per patient. MRI protocols could be refined to optimise ...

وصف الملف: application/pdf; text/xml

العلاقة: https://www.repository.cam.ac.uk/handle/1810/310005Test

الإتاحة: https://doi.org/10.17863/CAM.57096Test
https://www.repository.cam.ac.uk/handle/1810/310005Test

المؤلفون: Jones, Victoria, Wykes, Victoria, Cohen, Nicki, Thompson, Dominic, Jacques, Tom S

المصدر: Histopathology

مصطلحات موضوعية: tethered cord syndrome, Clinical Deterioration, spinal cord untethering, adipocytes, Lumbosacral Region, Original Articles, Magnetic Resonance Imaging, lipomyelomeningocele, dysraphism, Humans, Original Article, lumbosacral lipoma, Lipoma, Spinal Cord Neoplasms, conus medullaris

الوصف: Aims Lumbosacral lipomas (LSL) are congenital disorders of the terminal spinal cord region that have the potential to cause significant spinal cord dysfunction in children. They are of unknown embryogenesis with variable clinical presentation and natural history. It is unclear whether the spinal cord dysfunction reflects a primary developmental dysplasia or whether it occurs secondarily to mechanical traction (spinal cord tethering) with growth. While different anatomical subtypes are recognised and classified according to radiological criteria, these subtypes correlate poorly with clinical prognosis. We have undertaken an analysis of surgical specimens in order to describe the spectrum of histological changes that occur and have correlated the histology with the anatomical type of LSL to determine if there are distinct histological subtypes. Methods and results The histopathology was reviewed of 64 patients who had undergone surgical resection of LSL. The presence of additional tissues and cell types were recorded. LSLs were classified from pre‐operative magnetic resonance imaging (MRI) scans according to Chapman classification. Ninety‐five per cent of the specimens consisted predominantly of mature adipocytes with all containing thickened bands of connective tissue and peripheral nerve fibres, 91% of samples contained ectatic blood vessels with thickened walls, while 22% contained central nervous system (CNS) glial tissue. Additional tissue was identified of both mesodermal and neuroectodermal origin. Conclusions Our analysis highlights the heterogeneity of tissue types within all samples, not reflected in the nomenclature. The diversity of tissue types, consistent across all subtypes, challenges currently held notions regarding the embryogenesis of LSLs and the assumption that clinical deterioration is due simply to tethering.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::4acb13ce549d83162a75455d8a2dbf9eTest
http://europepmc.org/articles/PMC5969216Test

المؤلفون: Cheung, Moira S., Irving, Melita, Cocca, Alessandra, Santos, Rui, Shaunak, Meera, Dougherty, Harry, Siddiqui, Ata, Gringras, Paul, Thompson, Dominic

المصدر: Archives of Disease in Childhood; Feb2021, Vol. 106 Issue 2, p180-184, 5p

مصطلحات موضوعية: UMBILICAL cord clamping, SUDDEN infant death syndrome, CERVICAL cord, INFANTS, ACHONDROPLASIA, INFANT mortality, SYRINGOMYELIA, DECISION trees, NEWBORN screening, PREDICTIVE tests, STENOSIS, OCCIPITAL bone, MAGNETIC resonance imaging, SURGICAL decompression, SEVERITY of illness index, ALGORITHMS

مستخلص: Background: Achondroplasia is associated with foramen magnum stenosis (FMS) and significant risk of morbidity and sudden death in infants. A sensitive and reliable method of detecting infants who require decompressive surgery is required. This study aims to describe the incidence and severity of FMS in an unselected, sequential series of infants using a novel MRI score and retrospectively correlate severity with clinical examination and cardiorespiratory sleep (CRS) studies.Methods: The Achondroplasia Foramen Magnum Score (AFMS) was developed and scores were retrospectively correlated with clinical and CRS data over a 3-year period.Results: Of 36 infants (M:F, 18:18), 2 (5.6%) did not have FMS (AFMS0); 13 (36.1%) had FMS with preservation of the cerebrospinal fluid (CSF) spaces (AFMS1); 3 (8.3%) had FMS with loss of the CSF space but no spinal cord distortion (AFMS2); 13 (36.1%) had FMS with flattening of the cervical cord without signal change (AFMS3); and 5 (13.9%) had FMS resulting in cervical cord signal change (AFMS4). Mean Total Apnea and Hypopnea Index (TAHI) for AFMS0-4 was 3.4, 6.41, 2.97, 10.5 and 25.8, respectively. Severe TAHI had a specificity of 89% but only a 59% sensitivity for AFMS3-4. Neurological examination was normal in 34/36 (94%) patients. Overall, 9/36 (25%) infants required neurosurgery with minimal surgical complications.Conclusions: Clinical examination and CRS have a low sensitivity for predicting the effects of foramen stenosis on the spinal cord. Routine screening with MRI using AFMS can aid in detecting early spinal cord changes and has the potential to reduce infant morbidity and mortality. [ABSTRACT FROM AUTHOR]

: Copyright of Archives of Disease in Childhood is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Layard Horsfall, Hugo, Chari, Aswin, Huttunen, Terhi, Simcock, Clare, D'Arco, Felice, Thompson, Dominic

المصدر: Child's Nervous System; Nov2019, Vol. 35 Issue 11, p2163-2169, 7p

مصطلحات موضوعية: LIPOMA, SPINE, SPINA bifida, ARNOLD-Chiari deformity, LUMBOSACRAL region, DERMOID cysts

مستخلص: Purpose: Lumbosacral lipoma (LSL) is a severe occult spinal dysraphism, frequently associated with neurological, urological and orthopaedic complications. Whole spine imaging is typically performed to identify concomitant, but spatially separate, congenital anomalies. Our hypothesis: the incidence of additional, clinically significant abnormalities of the neuraxis is low; thus, imaging should be optimised at the lumbosacral region. We aim to assess the prevalence and relevance of LSL-associated lesions. Method: A single-centre, retrospective, radiological review using a prospectively maintained operative database. Inclusion criteria: children (< 16 years) with confirmed diagnosis of LSL and received whole spine MRI. Fatty filum, syndromic cases and cutaneous stigmata above lesion level were excluded. Data was extracted from radiological imaging, reports and clinical correspondence. Results: One hundred twelve patients (40:72, M:F) aged 0.5 years (0.2–2.7) (median ± IQR) with LSL had whole spine MRI between 2001 and 2017. Classification of LSL: transitional 48 (43%); dorsal 30 (27%); caudal 28 (25%) and chaotic 6 (5%). Additional anomalies included syringohydromyelia 44 (39%), subcutaneous tract 19 (17%), abnormal vertebral segmentation 18 (16%), dermoid cyst 1 and 1 Chiari I deformity. There were no Chiari II malformations. No child required surgery for an associated lesion. Binary logistic regression revealed no factors associated with predicting secondary lesions. Conclusions: In congenital LSL, additional anomalies of the neuraxis are typically loco-regional rather than pan-CNS and additional lesions are rarely clinically significant. The loco-regional distribution of anomalies suggests that only lumbosacral spinal imaging is required in the initial evaluation of LSL. Such a policy would lessen the anaesthetic/sedation time for children and reduce imaging cost per patient. MRI protocols could be refined to optimise imaging quality at the region of interest. [ABSTRACT FROM AUTHOR]

: Copyright of Child's Nervous System is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Jones, Victoria¹, Thompson, Dominic¹

المصدر: Child's Nervous System. Aug2018, Vol. 34 Issue 8, p1557-1562. 6p.

مصطلحات موضوعية: *LUMBOSACRAL region, *HUMAN abnormalities, *CEREBRAL dominance, *SPINAL canal, *HERNIA

مستخلص: Purpose: Rotation of the lipoma-neural placode has been noted in transitional lumbosacral lipomas. The purpose of this study was to confirm this rotation; that this rotation occurs with a preference to the left, and correlates with clinical symptoms. In addition, this study tests the hypothesis that this rotation occurs through local mechanical forces rather than intrinsic congenital malformation.Methods: Lipomas were classified as per the Chapman classification. Degree of rotation of the placode from the coronal plane was recorded along with the presence of herniation outside of the vertebral canal. Abnormalities on urodynamic testing were recorded, along with neuro-orthopaedic signs picked up on formal neuro-physiotherapy assessment.Results: Placode rotation occurs more frequently in the transitional group. Regardless of lipoma classification, rotation was much more common to the left. Furthermore, when lateralisation of symptoms was present, this strongly correlated with the direct of rotation. There was no difference in rotation of the placode whether it was within (lipomyelocoele) or without the vertebral canal (lipomyelomeningocoele).Conclusions: Placode rotation is a feature of transitional lumbosacral lipomas and may account for the increase in symptoms amongst this subgroup. Herniation of the placode outside the vertebral canal does not increase the risk of rotation suggesting a congenital cause for this finding rather than a purely mechanical explanation. [ABSTRACT FROM AUTHOR]

المؤلفون: Kabir, Syed Mohammed Rezaul^1,2 rezaulkabir@hotmail.com, Thompson, Dominic^1,3, Rezajooi, Kia^1,2, Casey, Adrian T. H.^1,2

المصدر: Acta Neurochirurgica. Jul2010, Vol. 152 Issue 7, p1139-1144. 6p. 2 Black and White Photographs, 1 Diagram, 1 Chart.

مصطلحات موضوعية: *LIPOSARCOMA, *SPINAL cord, *MAGNETIC resonance imaging, *LAMINECTOMY, *CEREBROVASCULAR disease, *THERAPEUTICS

مستخلص: Non-dysraphic intradural spinal cord lipomas are rare lesions and the management remains controversial. We present our experience with five cases and propose guidelines for their management. Five patients who underwent surgery for non-dysraphic spinal cord lipomas between January 2004 and April 2009 were retrospectively reviewed. All had varying degrees of neurological symptoms at the time of surgery with characteristic features on magnetic resonance imaging (MRI). All patients underwent decompression with a laminectomy/laminoplasty and debulking. The dura was primarily closed in one patient. The literature was also extensively reviewed regarding these rare lesions and optimum management guidelines proposed. The age at presentation ranged from 17 to 52 years (mean 32.2). Minimum follow-up was 8 months and maximum follow-up was 5 years. There was neurological improvement following surgery in all cases. Post-operative MRI scan showed evidence of significant residual tumour in all patients. The extent of surgical resection does not necessarily correlate with clinical outcome. The aim of surgery should, therefore, be adequate decompression with preservation of neural structures. Aggressive debulking should be avoided. Onset of any neurological symptoms/signs, bowel or bladder symptoms or intractable local symptoms should be an indication for surgery. [ABSTRACT FROM AUTHOR]

المؤلفون: Thompson, Dominic N. P.¹ (AUTHOR) dominic.thompson@gosh.nhs.uk

المصدر: Child's Nervous System. Jan2020, Vol. 36 Issue 1, p9-9. 1p.

مصطلحات موضوعية: *SPINE, *LIPOMA, *MAGNETIC resonance imaging, *SPINAL cord

مستخلص: Letter of response re "Whole spine MRI is not required in investigating uncomplicated paediatric lumbosacral lipoma. The patients in our series had not undergone surgery at the time of the MRI scan. The extended LSL MRI protocol suggested by Prof Wang is interesting and might provide a pragmatic compromise between local and whole neuraxis imaging. [Extracted from the article]

المؤلفون: Grieve, Joan¹, Thompson, Dominic¹ thompd@gosh.nhs.uk

المصدر: Pediatric Neurosurgery. Sep2001, Vol. 35 Issue 3, p164-165. 2p. 2 Black and White Photographs.

مصطلحات موضوعية: *BRAIN diseases, *HYDROCEPHALUS in children, *PEDIATRIC neurology, *MAGNETIC resonance imaging, *DIAGNOSTIC imaging, *ENDOSCOPIC surgery

مستخلص: Deals with the resolution of tonsillar herniation following endoscopic third ventriculostomy performed on a 15 year-old girl. Symptoms manifested by the child; Result of the clinical examination and magnetic resonance imaging brain scan conducted on the child; Information on hydrocephalus.