Akademik Veri Yönetim Sistemi
Frontiers in Surgery, cilt.12, 2025 (SCI-Expanded, Scopus)
Background: The interhemispheric transcallosal (ITA) and endoscopic approaches (EA) are established treatments for third ventricle colloid cysts (TVCCs); however, their relative parenchymal impact and the progression of associated MRI changes from early to late postoperative stages remain undefined. Objective: To compare early volumetric MRI findings after ITA and EA for TVCC resection and determine whether early parenchymal injury persisted on late imaging. Methods: Twenty-three patients (ITA, 13; EA, 10) with early and late postoperative MRI were retrospectively reviewed. Early T2/FLAIR hyperintensity volumes were segmented along the surgical tract (burr-hole tract subtracted in EA). DWI/ADC imaging assessed diffusion restriction. Late MRI evaluated gliosis, encephalomalacia, and parenchymal loss. Statistical, correlation, and sensitivity analyses assessed associations while adjusting for cyst size and hydrocephalus. Results: Early MRI hyperintensity volume was smaller after ITA than EA (349 ± 218 mm3 vs. 2,952 ± 2,084 mm3; p < 0.001). Diffusion restriction occurred in 7.7% of ITA and 50% of EA (p = 0.052). Gliosis, encephalomalacia, and parenchymal loss on late MRI were absent after ITA but present in 50% of EA cases (p = 0.007 each), with larger early volumes in EA associated with gliosis (p = 0.032), encephalomalacia, and parenchymal loss (p = 0.016 each). These associations persisted after adjusting for cyst size and hydrocephalus. Gross total resection occurred in 92% of ITA and 50% of EA cases (p = 0.039). Conclusions: Compared with ITA, EA produced larger early parenchymal injury, half of which persisted as structural abnormalities on late imaging, indicating more persistent radiologic change.