Abstract:
:OBJECTIVE Treatment with a BRAF mutation inhibitor might shrink otherwise refractory craniopharyngiomas and is a promising preoperative treatment to facilitate tumor resection. The aim of this study was to investigate the noninvasive diagnosis of BRAF-mutated craniopharyngiomas based on MRI characteristics. METHODS Fifty-two patients with pathologically diagnosed craniopharyngioma were included in this study. Polymerase chain reaction was performed on tumor tissue specimens to detect BRAF and CTNNB1 mutations. MRI manifestations-including tumor location, size, shape, and composition; signal intensity of cysts; enhancement pattern; pituitary stalk morphology; and encasement of the internal carotid artery-were analyzed by 2 neuroradiologists blinded to patient identity and clinical characteristics, including BRAF mutation status. Results were compared between the BRAF-mutated and wild-type (WT) groups. Characteristics that were significantly more prevalent (p < 0.05) in the BRAF-mutated craniopharyngiomas were defined as diagnostic features. The minimum number of diagnostic features needed to make a diagnosis was determined by analyzing the receiver operating characteristic (ROC) curve. RESULTS Eight of the 52 patients had BRAF-mutated craniopharyngiomas, and the remaining 44 had BRAF WT tumors. The clinical characteristics did not differ significantly between the 2 groups. Interobserver agreement for MRI data analysis was relatively reliable, with values of Cohen κ ranging from 0.65 to 0.97 (p < 0.001). A comparison of findings in the 2 patient groups showed that BRAF-mutated craniopharyngiomas tended to be suprasellar (p < 0.001), spherical (p = 0.005), predominantly solid (p = 0.003), and homogeneously enhancing (p < 0.001), and that patients with these tumors tended to have a thickened pituitary stalk (p = 0.014). When at least 3 of these 5 features were present, a tumor might be identified as BRAF mutated with a sensitivity of 1.00 and a specificity of 0.91. The area under the ROC curve for the sum of all 5 diagnostic criteria was 0.989 (p < 0.001). CONCLUSIONS The BRAF mutation status of craniopharyngiomas might be predicted using certain MRI features with relatively high sensitivity and specificity, thus offering potential guidance for the preoperative administration of BRAF mutation inhibitors.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Yue Q,Yu Y,Shi Z,Wang Y,Zhu W,Du Z,Yao Z,Chen L,Mao Ydoi
10.3171/2017.4.JNS163113subject
Has Abstractpub_date
2018-07-01 00:00:00pages
27-34issue
1eissn
0022-3085issn
1933-0693pii
2017.4.JNS163113journal_volume
129pub_type
杂志文章abstract:OBJECT:Middle cerebral artery (MCA) aneurysms can be difficult to detect and characterize. The authors describe the utility and impact of helical computerized tomography (CT) angiography for the evaluation of aneurysms in this location, and compare this modality with digital subtraction (DS) angiography and intraoperat...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2002.97.6.1322
更新日期:2002-12-01 00:00:00
abstract::Stereotactic radiosurgery emerged as a neurosurgical discipline in order to utilize energy for the manipulation of brain or nerve tissue, with the goal of minimal access and safe and effective care of a spectrum of neurosurgical disorders. Perhaps no other branch of neurosurgery has been so disruptive across the entir...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2019.2.JNS181712
更新日期:2019-06-01 00:00:00
abstract::The authors report a case of cerebral aspergillosis. This is only the fifth case following intracranial surgery noted in the literature. Pathogenesis, angiographic findings, and results of cerebrospinal fluid culture are discussed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.2.0308
更新日期:1978-08-01 00:00:00
abstract:OBJECT:Patients with subarachnoid hemorrhage (SAH) and their close friends and family may be excessively fearful that the patient will have a recurrence, and such fears could play a critical role in the poor recovery shown by many patients The authors examined whether these fears could account for significant variance ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.5.JNS121688
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:The present study was designed to explore the association between facility type (academic center [AC] vs non-AC), facility volume (high-volume facility [HVF] vs low-volume facility [LVF]), and outcomes of glioblastoma (GBM) treatment. METHODS:Based on the National Cancer Database (NCDB), GBM patients were ca...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.10.JNS182247
更新日期:2019-02-15 00:00:00
abstract:OBJECT:The reduction in the level of nitric oxide (NO) is a purported mechanism of delayed vasospasm after subarachnoid hemorrhage (SAH). Evidence in support of a causative role for NO includes the disappearance of nitric oxide synthase (NOS) from the adventitia of vessels in spasm, the destruction of NO by hemoglobin ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.92.1.0121
更新日期:2000-01-01 00:00:00
abstract::The treatment of patients with low-grade gliomas remains a subject of controversy, especially with respect to new treatment modalities such as interstitial radiosurgery (brachytherapy), radiosurgery, and stereotactic radiotherapy. In a retrospective analysis conducted between 1979 and 1991, the authors studied the res...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1995.82.3.0418
更新日期:1995-03-01 00:00:00
abstract::Monitoring of cerebral oxygenation is considered to be of great importance in minimizing secondary hypoxic and ischemic brain damage following severe head injury. Although the threshold for cerebral hypoxia in jugular bulb oximetry (measurement of O2 saturation in the jugular vein (SjvO2)) is generally accepted to be ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.5.0751
更新日期:1996-11-01 00:00:00
abstract::OBJECTIVEExcessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.9.JNS17996
更新日期:2018-11-01 00:00:00
abstract:OBJECT:The use of focal brain cooling to eliminate epileptic discharges (EDs) has attracted increasing attention in the scientific community. In this study, the inhibitory effect of selective hippocampal cooling on experimental hippocampal seizures was investigated using a newly devised cooling system with a thermoelec...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/108/4/0791
更新日期:2008-04-01 00:00:00
abstract::Susceptibility weighted imaging (SWI) is a relatively new imaging technique. Its high sensitivity to hemorrhagic components and ability to depict microvasculature by means of susceptibility effects within the veins allow for the accurate detection, grading, and monitoring of brain tumors. This imaging modality can als...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2015.1.JNS142349
更新日期:2015-12-01 00:00:00
abstract::The direct cortical response (DCR), an electrical potential recorded in the immediate vicinity of a surface cortical stimulus, shows a configuration in the primary sensory areas of animals that is different from the one observed in association cortex. This suggested the possibility that systematic study of the DCR in ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.4.0701
更新日期:1994-04-01 00:00:00
abstract::Surgical sacrifice of the carotid artery is a frequently anticipated event during the treatment of certain aneurysms and tumors. The ability to predict tolerance to carotid artery occlusion is therefore of benefit when planning procedures in which the carotid artery is at risk. A trial of carotid artery occlusion usin...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.1.0015
更新日期:1994-07-01 00:00:00
abstract:OBJECT:Twenty-nine nonimmunocompromised patients with primary central nervous system (CNS) lymphoma were treated with high-dose methotrexate (MTX) therapy followed by irradiation. The authors investigated the correlation of infusion schedules with MTX penetration into cerebrospinal fluid (CSF), tumor response, and surv...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.91.2.0221
更新日期:1999-08-01 00:00:00
abstract::A case is reported of a patient in whom an intracranial extracerebral melanoma developed in association with a life-long nevus of Ota. Melanotic pigmentation of the skull, periosteum, and meninges beneath the nevus was found at operation. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.2.0280
更新日期:1983-02-01 00:00:00
abstract::A case-control analysis was performed to evaluate the association of 15 potential risk factors with postoperative infection in neurosurgical patients. All infections that developed postoperatively on the neurosurgical service at the University of Minnesota from January, 1970, to March, 1984, were identified. Among the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.6.0902
更新日期:1986-06-01 00:00:00
abstract::Desmoplastic small round cell tumors (DSRCTs) are rare, aggressive neoplasms that typically arise from abdominal and pelvic peritoneum in young adults. Other primary sites are uncommon, and an intracranial origin is exceptionally rare. Here the authors report the first case of a DSRCT presenting as a primary suprasell...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS132490
更新日期:2015-04-01 00:00:00
abstract::OBJECTIVE Mutations in the isocitrate dehydrogenase (IDH) genes are of proven diagnostic and prognostic significance for cerebral gliomas. The objective of this study was to evaluate the clinical feasibility of using a recently described method for determining IDH mutation status by using magnetic resonance spectrosco...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.10.JNS161793
更新日期:2018-02-01 00:00:00
abstract:OBJECT:The goal of this paper was to investigate the long-term outcome and the possible prognostic factors that might have influenced the persistence of posttraumatic epilepsy after penetrating head injuries sustained during the Iraq-Iran war (1980-1988). METHODS:In this retrospective study, the authors evaluated 189 ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.4.17519
更新日期:2009-02-01 00:00:00
abstract:OBJECT:Bone morphogenetic proteins (BMPs) have been shown to have significant osteoinductive activity in numerous in vitro and in vivo assay systems, and BMP-2 and BMP-7 are currently being evaluated in human clinical studies. In the spinal region, BMPs have been shown to promote spinal arthrodesis at a higher rate tha...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2000.92.2.0191
更新日期:2000-04-01 00:00:00
abstract:OBJECT:The concept of the flow-diverter stent (FDS) is to induce aneurysmal thrombosis while preserving the patency of the parent vessel and any covered branches. In some circumstances, it is impossible to avoid dangerously covering small branches, such as the anterior choroidal artery (AChA), with the stent. In this p...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.11.JNS141603
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:It is common practice to use a new contralateral bur hole for ventriculoperitoneal shunt (VPS) placement in subarachnoid hemorrhage (SAH) patients with an existing ventriculostomy. At Thomas Jefferson University and Jefferson Hospital for Neuroscience, the authors have primarily used the ventriculostomy site ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.6.JNS132638
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:MRI scans obtained within 48-72 hours (early postoperative MRI [epMRI]), prior to any postoperative reactive changes, are recommended for the accurate assessment of the extent of resection (EOR) after glioma surgery. Diffusion-weighted imaging (DWI) enables ischemic lesions to be detected and distinguished fr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.3.JNS172516
更新日期:2018-08-10 00:00:00
abstract::The clinical and angiographic findings of 55 patients with a spinal dural arteriovenous malformation (AVM) are reviewed, and the results of surgery assessed. The symptoms of dural AVM are usually gradual in onset, and hemorrhage from this type of AVM is less common than in true spinal cord angiomas. Other clinical fea...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.2.0238
更新日期:1984-02-01 00:00:00
abstract::Of the various anterior surgical approaches to the spine, exposure of the upper two thoracic vertebrae remains the most challenging. An operative approach to this region is described. The major features include resection of a portion of the clavicle and the manubrium sterni. Following resection of the tumor and involv...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.4.0686
更新日期:1984-10-01 00:00:00
abstract::Intracranial arteriovenous malformations (AVM's) have been classified as pure pial, pure dural, and mixed pial and dural. Dural AVM's are relatively uncommon, with 377 cases documented up to 1990. These lesions were believed to be situated within the walls of the sinuses, but during the last decade researchers discove...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.4.0620
更新日期:1994-10-01 00:00:00
abstract:OBJECT:The goal in this study was to compare flat-panel detector (FD) CT with multislice (MS) CT in the visualization of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), intraventricular hemorrhage, and external ventricular drains (EVDs) to evaluate the diagnostic quality and limitations of the new FD CT ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.2.JNS091054
更新日期:2010-10-01 00:00:00
abstract::A 10-year-old boy had a sore throat, followed in 4 weeks by acute rheumatic fever and in 6 weeks by atlanto-axial dislocation. Reduction of the dislocation by means of a halo vest relieved his pain, but the cervical spine remained unstable after 3 months of immobilization and required an occiput-C1-2 fusion and rib gr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.66.2.0286
更新日期:1987-02-01 00:00:00
abstract::The authors report the case of an adult patient with irreducible fixed dystonia (inward rotation) of the right foot that arose after cardioembolic ischemia of the left putamen and globus pallidus externus. Given the resistance of such symptomatology to all of the attempted conservative treatments (including botulinum ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2009.4.JNS08785
更新日期:2009-12-01 00:00:00
abstract:OBJECT:Until now there has been no reliable stimulation protocol for inducing transient language disruptions while mapping Broca's area. Despite the promising data of only a few studies in which speech arrest and language disturbances have been induced, certain concerns have been raised. The purpose of this study was t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.11.JNS13952
更新日期:2014-05-01 00:00:00