title: Correlation among magnetic resonance imaging findings, prognostic factors for survival, and histological diagnosis of intrinsic brainstem lesions in children.
abstract: OBJECTIVE
  The aim of this study was to compare MR imaging characteristics with histopathological findings of intrinsic brainstem lesions and also to show the prognostic factors in patients with diffuse brainstem glioma.
  
  
  METHODS
  Between February 1988 and August 2007, 44 brainstem biopsies were performed at the Roger Salengro Hospital in Lille, France, in children with intrinsic brainstem lesions not amenable to excision. Twenty-six were female and 18 male, and the mean age was 6 years.
  
  
  RESULTS
  Histological evaluation revealed diffuse brainstem glioma in all patients with diffuse nonenhancing brainstem lesions. Diffuse brainstem glioma was found in 18 patients (90%) with diffuse enhancing brainstem lesions. Pathological entities different from diffuse glioma were verified in 2 patients (10%)-1 with ependymoma and 1 with ganglioglioma. In 4 of 5 patients with a focal nonenhancing brainstem lesion, the histopathological diagnosis was diffuse low-grade glioma. In 6 of 10 patients with focal enhancing brainstem lesion, the diagnosis was diffuse brainstem glioma, and pathological entities different from diffuse brainstem glioma were verified in 2 (20%), both with pilocytic astrocytoma. The mean 1-year actuarial survival rates for patients classified with low-grade and high-grade glioma were 80.4% ± 0.08% and 48.6% ± 0.14%, respectively.
  
  
  CONCLUSIONS
  The impact of stereotactic biopsy on intrinsic brainstem lesions was greater in patients with MR imaging-documented enhancing lesions in whom the diagnosis of diffuse glioma was less frequent. Patients with low-grade glioma seem to have longer survival than those with high-grade glioma.
authors: Department of Neurosurgery, CHRU Hôpital Roger Salengro, Lille, France. mdellaretti@mac.com
authors: Marcos
authors: M
authors: Dellaretti
authors: Gustavo
authors: G
authors: Touzet
authors: Nicolas
authors: N
authors: Reyns
authors: François
authors: F
authors: Dubois
authors: Sebastião
authors: S
authors: Gusmão
authors: Júlio Leonardo Barbosa
authors: JL
authors: Pereira
authors: Serge
authors: S
authors: Blond
mesh_terms: D001706:Biopsy / Q000379:methods; D001933:Brain Stem / Q000473:pathology*; D020295:Brain Stem Neoplasms / Q000175:diagnosis / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D013238:Stereotaxic Techniques