儿童松果体区病变是异质性病变，通常因闭塞性脑积水而导致颅内压 (ICP) 升高。用于评估脑积水的 MRI 衍生参数包括作为 ICP 替代值的视神经鞘直径 (ONSD) 和代表脑室容积的额枕角比 (FOHR)。由于 ICP 升高可能并不总是与临床症状相关，ONSD 的辅助治疗可以帮助接受治疗的患者做出决策。本研究的目的是评估接受手术治疗的松果体区病变患者术前和术后 ONSD 和 FOHR 的可用磁共振成像 (MRI) 作为脑积水的指标。对所有手术患者进行回顾性数据分析2010 年至 2023 年间三级护理中心的松果体区病变。仅选择接受术前和术后 MRI 的患者纳入。分析了多个时间点的临床数据和 ONSD 以及 FOHR。影像参数变化与手术治疗前后脑积水的临床症状相关。40例手术病例中33例符合纳入标准。诊断时的年龄为 10.9±4.6 岁（1-17 岁）。 80%的手术病例术前出现脑积水（n = 32/40）。脑积水的存在与术前 ONSD 显着升高相关（p = 0.006）。术后立即 (p< 0.001) 和术后 3 个月 (p< 0.001) ONSD 显着下降。 FOHR 显示​​出稍微不太明显的下降（立即 p = 0.006，3 个月 p = 0.003）。在无脑积水的患者中，未观察到 ONSD 的显着变化（p = 0.369）。在 6/6 临床脑积水治疗失败的患者中，ONSD 增加，但在 3/6 患者中，ONSD 是唯一可辨别的 MRI 变化，而 FOHR 不变。ONSD 测量可能有助于评估松果体区肿瘤患者脑积水引起的颅内高压。 ONSD 的变化似乎对评估脑积水治疗失败具有价值。© 2024。作者获得 Springer-Verlag GmbH Austria（Springer Nature 旗下公司）的独家许可。

Pineal region lesions in children are heterogenous pathologies often symptomatic due to occlusive hydrocephalus and thus elevated intracranial pressure (ICP). MRI-derived parameters to assess hydrocephalus are the optic nerve sheath diameter (ONSD) as a surrogate for ICP and the frontal occipital horn ratio (FOHR), representing ventricle volume. As elevated ICP may not always be associated with clinical signs, the adjunct of ONSD could help decision making in patients undergoing treatment. The goal of this study is to assess the available magnetic resonance imaging (MRI) of patients with pineal region lesions undergoing surgical treatment with respect to pre- and postoperative ONSD and FOHR as an indicator for hydrocephalus.Retrospective data analysis was performed in all patients operated for pineal region lesions at a tertiary care center between 2010 and 2023. Only patients with pre- and postoperative MRI were selected for inclusion. Clinical data and ONSD at multiple time points, as well as FOHR were analyzed. Imaging parameter changes were correlated with clinical signs of hydrocephalus before and after surgical treatment.Thirty-three patients with forty operative cases met the inclusion criteria. Age at diagnosis was 10.9 ± 4.6 years (1-17 years). Hydrocephalus was seen in 80% of operative cases preoperatively (n = 32/40). Presence of hydrocephalus was associated with significantly elevated preoperative ONSD (p = 0.006). There was a significant decrease in ONSD immediately (p < 0.001) and at 3 months (p < 0.001) postoperatively. FOHR showed a slightly less pronounced decrease (immediately p = 0.006, 3 months p = 0.003). In patients without hydrocephalus, no significant changes in ONSD were observed (p = 0.369). In 6/6 patients with clinical hydrocephalus treatment failure, ONSD increased, but in 3/6 ONSD was the only discernible MRI change with unchanged FOHR.ONSD measurements may have utility in evaluating intracranial hypertension due to hydrocephalus in patients with pineal region tumors. ONSD changes appear to have value in assessing hydrocephalus treatment failure.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.