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Características imagiológicas de tumores do sistema nervoso central em idade pediátrica
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Introdução: Os tumores do Sistema Nervoso Central (SNC) são a segunda causa de cancro mais comum em idade pediátrica, estando associados a elevadas taxas de morbimortalidade em todas as idades. Os exames de imagem, nomeadamente a Tomografia Computorizada (TC) e a Ressonância Magnética (RM) são a chave para o diagnóstico destes tumores, bem como para a diferenciação entre lesões benignas e malignas, caracterização, avaliação da extensão e vigilância evolutiva da lesão.
Objetivos: Caracterização dos tumores pediátricos do SNC quanto às características epidemiológicas, clínicas e imagiológicas e, avaliação da concordância entre o diagnóstico imagiológico e o diagnóstico histopatológico das lesões identificadas.
Métodos: Estudo observacional, descritivo e retrospetivo de dados epidemiológicos, clínicos e imagiológicos de estudos de TC e RM, de doentes com idades compreendidas entre os 0 e os 18 anos e diagnóstico inaugural de tumor do SNC, entre janeiro de 2019 e agosto de 2022. Os dados foram recolhidos da base de dados Byme® e da plataforma Sectra IDS7 do Serviço de Imagiologia Neurológica do Hospital de Santa Maria – Centro Hospitalar Lisboa Norte.
Resultados: Foram identificados 82 doentes com lesão tumoral, dos quais 65 com diagnóstico histopatológico. As características epidemiológicas, clínicas e de imagem de todos os tipos tumorais identificados foram, na sua maioria, consistentes com a literatura. Também foram descritas características de raros e de novos tipos tumorais, ainda pouco reconhecidos no âmbito da Neurorradiologia. A concordância entre diagnósticos, imagiológico e histopatológico, foi de 60%.
Conclusão: É possível chegar a uma hipótese de diagnóstico imagiológico coincidente com o diagnóstico histopatológico, com base nos dados analisados. A falta de concordância entre diagnósticos evidencia, não só a importância e necessidade de técnicas avançadas de RM, como também as alterações e introdução de novos tipos tumorais nas várias edições da classificação de tumores do SNC da OMS, publicadas nos últimos anos.
Introduction: Central Nervous System (CNS) tumors are the second most common cause of cancer among children, being associated with high morbidity and mortality rates across all ages. Imaging tests like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are the key for identifying these tumors and differentiating benign from malignant lesions, as well as for characterizing, evaluating and monitoring a lesion. Objectives: To characterize childhood CNS tumors given their epidemiological, clinical and imaging characteristics, and to evaluate the agreement between the imaging diagnosis and the histopathological diagnosis of the identified lesions. Methods: An Observational, descriptive and retrospective study of epidemiological, clinical and imaging data from CT and MRI studies of patients aged between 0 and 18 years and with inaugural diagnosis of CNS tumor, between January 2019 and August 2022. The data used was gathered from both Byme® database and Sectra IDS7 platform of the Neurological Imaging Service of the Hospital de Santa Maria – Centro Hospitalar Lisboa Norte. Results: A total of 82 patients with tumor lesions were identified, of which 65 had histopathological diagnosis. The epidemiological, clinical and imaging characteristics of all tumor types identified were mostly consistente with the literature. Moreover, several characteristics of rare and new tumor types, still under-recognized in the field of Neuroradiology, were described. The agreement between the imaging and histopathological diagnoses was 60%. Conclusions: It is possible to arrive at a hypothesis of imaging diagnosis coincident with the histopathological diagnosis, based on the analyzed data. The lack of agreement between diagnoses reflects both the importance and the need for advanced MRI techniques, as well as the changes and introduction of new tumor types in the various editions of the WHO CNS classification published over the last few years.
Introduction: Central Nervous System (CNS) tumors are the second most common cause of cancer among children, being associated with high morbidity and mortality rates across all ages. Imaging tests like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are the key for identifying these tumors and differentiating benign from malignant lesions, as well as for characterizing, evaluating and monitoring a lesion. Objectives: To characterize childhood CNS tumors given their epidemiological, clinical and imaging characteristics, and to evaluate the agreement between the imaging diagnosis and the histopathological diagnosis of the identified lesions. Methods: An Observational, descriptive and retrospective study of epidemiological, clinical and imaging data from CT and MRI studies of patients aged between 0 and 18 years and with inaugural diagnosis of CNS tumor, between January 2019 and August 2022. The data used was gathered from both Byme® database and Sectra IDS7 platform of the Neurological Imaging Service of the Hospital de Santa Maria – Centro Hospitalar Lisboa Norte. Results: A total of 82 patients with tumor lesions were identified, of which 65 had histopathological diagnosis. The epidemiological, clinical and imaging characteristics of all tumor types identified were mostly consistente with the literature. Moreover, several characteristics of rare and new tumor types, still under-recognized in the field of Neuroradiology, were described. The agreement between the imaging and histopathological diagnoses was 60%. Conclusions: It is possible to arrive at a hypothesis of imaging diagnosis coincident with the histopathological diagnosis, based on the analyzed data. The lack of agreement between diagnoses reflects both the importance and the need for advanced MRI techniques, as well as the changes and introduction of new tumor types in the various editions of the WHO CNS classification published over the last few years.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Tumores do sistema nervoso central Idade pediátrica Tomografia computorizada Ressonância magnética Imagiologia