Clinical Characteristics and Neuroimaging Findings in 12 Cases of Recurrent Glioblastoma With Communicating Hydrocephalus
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概要
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Clinically, recurrent glioblastoma multiforme (GBM) is often associated with communicating hydrocephalus. We hypothesized that there are specific magnetic resonance (MR) imaging findings at the diagnosis of recurrent GBM that predict subsequent hydrocephalus. Various clinical characteristics were investigated including outcome and MR imaging findings in 12 patients with recurrent GBM followed by hydrocephalus (Hydro group) and 21 patients with recurrent GBM without hydrocephalus (Non-hydro group). Patient age and presence of communicating hydrocephalus were significantly associated with poor outcome. Median survival with recurrent GBM was longer in the Non-hydro group than in the Hydro group. Low Karnofsky performance status (KPS) and poor recursive partitioning analysis (RPA) class (RPA class 3, 5, 6, or 7) at the diagnosis of recurrent GBM were associated with the presence of hydrocephalus. The incidence of leptomeningeal dissemination after recurrent GBM was higher in the Hydro group than in the Non-hydro group. Evans index and fractional anisotropy value showed no difference at the diagnosis of recurrent GBM, but some MR imaging findings indicated that lesion attached to the basal cistern and/or ventricle was closely associated with subsequent hydrocephalus. We recommend careful monitoring of the ventricle size and leptomeningeal dissemination, especially in patients with low KPS and/or poor RPA class, if MR imaging indicates that the lesion is attached to the basal cistern and/or ventricle at recurrence of GBM.
著者
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Ishikawa Eiichi
Department Of Medicine And Clinical Science Graduate School Of Medical Sciences Kyushu University
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Osuka Satoru
Department Of Neurosurgery Institute Of Clinical Medicine Graduate School Of Comprehensive Human Sci
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Matsuda Masahide
Department Of Neurosurgery Institute Of Clinical Medicine University Of Tsukuba
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Yamamoto Tetsuya
Department Of Astronomy School Of Science The University Of Tokyo
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Zaboronok Alexander
Department Of Neurosurgery Graduate School Of Comprehensive Human Sciences University Of Tsukuba
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MATSUMURA Akira
Department of Electronic Science and Engineering, Faculty of Engineering, Kyoto University
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MASUMOTO Tomohiko
Department of Intervention and Radiology, Faculty of Medicine, University of Tsukuba
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HIRATA Koji
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
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ONUMA Kuniyuki
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
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