[Magnetic Resonance Imaging for Diagnosis of Idiopathic Pediatric Meningiomas].

Objective To analyze the radiological features of idiopathic pediatric meningiomas and explore their relationships with pathological grading,misdiagnoses,and blood loss during surgery.Methods We retrospectively reviewed 29 cases of pathologically confirmed pediatric meningiomas with pre-operative magnetic resonance imaging in Beijing Tiantan Hospital from November 2014 to July 2018.We assessed the imaging features to explore their relationships with pathological grading,misdiagnoses,and blood loss during surgery. Results Among the 29 cases,7 intraparenchymal meningiomas,5 extraparenchymal meningiomas,4 ventricular meningiomas,and 1 transcranial meningioma were misdiagnosed.Tumor location was significantly associated with possibility of misdiagnoses(P=0.021),and intraparenchymal tumors were most likely to be misdiagnosed.Twelve patients had positive dural tail sign,and 4 of them were misdiagnosed;16 patients did not have dural tail sign,and 12 of them were misdiagnosed.Fisher exact test showed that positive dural tail sign was associated with decreased possibility of misdiagnoses(one-sided P=0.034).Univariable regression analysis showed that the feature of tumor surrounding arteries or interfering with veins(P=0.020)and the tumor maximum diameter(P=0.001)had positively linear relationships with blood loss volume during surgery.Combining these two variables,the multivariable regression model showed better fitting performance($R_{ad}^2$=0.468).Conclusions Pediatric meningiomas are extremely rare,with scarce radiological characteristics.They are hard to diagnose,and the intraparenchymal meningiomas are very likely to be misdiagnosed and therefore should be treated with extra caution.Among all the radiological features,tumor surrounding arteries or interfering with veins and tumor maximum diameter were associated with increased blood loss during surgery.

Magnetic Resonance Imaging for Diagnosis of Idiopathic Pediatric Meningiomas / 中国医学科学院学报

Objective To analyze the radiological features of idiopathic pediatric meningiomas and explore their relationships with pathological grading,misdiagnoses,and blood loss during surgery.Methods We retrospectively reviewed 29 cases of pathologically confirmed pediatric meningiomas with pre-operative magnetic resonance imaging in Beijing Tiantan Hospital from November 2014 to July 2018.We assessed the imaging features to explore their relationships with pathological grading,misdiagnoses,and blood loss during surgery. Results Among the 29 cases,7 intraparenchymal meningiomas,5 extraparenchymal meningiomas,4 ventricular meningiomas,and 1 transcranial meningioma were misdiagnosed.Tumor location was significantly associated with possibility of misdiagnoses(

Blood loss and duration of surgery are independent risk factors for complications after breast reconstruction.

BACKGROUND: Complications after breast reconstructive surgery are common, and they can be caused by a wide range of factors. The aim of the present study was to identify independent perioperative risk factors for postoperative complications after breast reconstruction. METHODS: A retrospective study was performed of 623 consecutive breast cancer patients who had undergone deep inferior epigastric perforator (DIEP) flap, latissimus dorsi (LD) flap, lateral thoracodorsal flap (LTDF), or tissue expander with secondary implant (EXP). Data on demography, perioperative parameters, and complications were collected. Logistic regression models adjusted to the reconstruction method and to confounding demographic factors were used for statistical analysis. RESULTS: Increased blood loss for each 10-ml step increased the risk for overall early complications (p = 0.017), early seroma (p = 0.037), early resurgery (p = 0.010), late local overall complications (p = 0.024), and late fat necrosis (p = 0.031). Longer duration of surgery for each 10-minute step increased the risk of overall early complications (p = 0.019), but, in the univariate model, there was an increased risk for nine different types of complications (p = 0.004-0.029). There was no association between the experience of the surgeon performing the procedure and the frequency of complications. CONCLUSIONS: Duration of surgery and blood loss during surgery are independent risk factors for postoperative complications, and should be minimised. Further research is needed to establish the association between the experience of the surgeon and the occurrence of complications.