Los gliomas son tumores cerebrales que se clasifican según su malignidad. La clasificación de un glioma depende de la histología y de características moleculares y genéticas, asociadas al pronóstico. Se pretende revisar la utilidad de métodos como la espectroscopía por resonancia magnética para la diferenciación de gliomas de bajo y alto grado como método no invasivo para predecir su comportamiento y así la sobrevida del paciente. Se revisan artículos publicados en inglés y español en los últimos 5 años en bases de dato como pubmed y embase, eliminándose artículos cuyo título, resumen o contenido no entraban dentro de los criterios de inclusión, resultando en un total de 35 artículos finales.

Utilidad de la Espectroscopía por Resonancia Magnética para la diferenciación de gliomas de alto y bajo grado.

Objective The clinical characteristics and imaging information of insular glioma patients were collected to predict mutation status of isocitrate dehydrogenase 1 (IDH1). Methods A total of 596 patients with gliomas confirmed by postoperative pathology in The First Affiliated Hospital with Nanjing Medical University from January 2011 to June 2021 were enrolled, including 72 insular gliomas, 213 frontal gliomas, 165 temporal gliomas, 76 parietal gliomas, 28 and 29 midline gliomas. All patients were examined by MRI, fifteen glioma⁃related features were selected from the visually accessible rembrandt images (VASARI), including enhancement quality, enhancement proportion, non⁃enhancement proportion, necrosis proportion, edema proportion, cyst, thickness of enhanced margin, definition of the enhanced margin, hemorrhage, diffusion, deep white matter involvement, deep ventricle involvement, midline cross, T2⁃FLAIR mismatch, maximum diameter of tumor. Univariate and multivariate Logistic regression analysis were used to screen the predictive factors related to IDH1⁃mutant in insular glioma. The receiver operating characteristic (ROC) curve was plotted and area under the curve (AUC), sensitivity and specificity were calculated to evaluate the predictive power of MRI features for IDH1⁃mutant glioma. Results IDH1 mutation rate was higher in insular and frontal gliomas (P＜0.01, for all). WHO grade Ⅱ had the highest IDH1 mutation rate (P=0.008, 0.000), and grade Ⅳ had the lowest mutation rate (P=0.000). The IDH1 mutation rate in low⁃expression Ki⁃67 gliomas was higher than that in high⁃expression gliomas (P=0.000). Logistic regression analysis showed that weak enhancement (OR=35.671, 95%CI: 2.805-453.600; P=0.006), non⁃enhancement (OR=75.453, 95%CI: 2.881-1872.759; P=0.009), unlimited diffusion (OR=10.573, 95%CI: 1.043-107.175; P=0.046), no deep ventricle involvement (OR=187.601, 95%CI: 2.269-15507.607; P=0.020), T2⁃FLAIR mismatch (OR=47.536, 95%CI: 2.838-796.097; P=0.007) were independent predictive factors for IDH1 mutation in insular glioma. The AUC of enhancement degree, diffusion, deep ventricle involvement and T2⁃FLAIR mismatch for the diagnosis of IDH1⁃mutant glioma were 0.846 (95%CI: 0.748-0.944, P=0.000), 0.730 (95%CI: 0.609-0.850, P=0.001), 0.708 (95%CI: 0.584-0.833, P=0.003) and 0.745 (95%CI: 0.627-0.864, P=0.000). The combination of the 4 groups had the highest diagnostic efficacy, and the AUC was 0.961 (95%CI: 0.923-0.999, P=0.000). Conclusions Low grade insular glioma has a high IDH1 mutation rate. MRI features of weak enhancement and non⁃enhancement, unlimited diffusion, non deep ventricle involvement and T2⁃FLAIR mismatch contribute to noninvasive prediction of IDH1⁃mutant insular glioma.

Clinical characteristics and MRI features of IDH-mutant in insular glioma

Diagnostic performance of edited 2HG MR spectroscopy of central glioma in the clinical environment

Novel modification of midline lumbar interbody fusion (mMIDLIF): a series of 28 patients

Percutaneous O-arm guided navigated screw implantation for C2 fractures: the technique adaptation according to Magerl and Judet

This article draws from the results of a survey that was aimed at giving an overview and exploring in detail what needs the parents of extremely premature infants have and what options of social support they are provided with, especially during the period of the spread and subsequent impact of the COVID-19 pandemic The research took place from the beginning of February 2020 until the beginning of September 2020 In the survey, 30 families participated from various countries, including Italy, Spain, the United States, Great Britain, Poland, Romania, and Ukraine The results of this survey can be applied to produce analyses that will serve as the basis for future relevant and innovative research on the impact of COVID-19 on the global population

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The Emphasis on the Relevant Needs of the Parents of Extremely Premature Infants with Special Regard to the Impact of COVID-19

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Diagnostic performance of edited 2HG MR spectroscopy of central glioma in the clinical environment

Novel modification of midline lumbar interbody fusion (mMIDLIF): a series of 28 patients

Percutaneous O-arm guided navigated screw implantation for C2 fractures: the technique adaptation according to Magerl and Judet

The Emphasis on the Relevant Needs of the Parents of Extremely Premature Infants with Special Regard to the Impact of COVID-19