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Diagnosis and Follow-up of Craniopharyngiomas With Transcranial Doppler Sonography

Divisions of Pediatric Neurology (K.-L.L., H.-S.W.) and Neurosurgery (T.-N.L.), Chang Gung Children's Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan, Republic of China.

Address correspondence and reprint requests to Huei-Shyong Wang, MD, Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, 5 Fu-Shin St, Kweishan 333, Taoyuan, Taiwan, Republic of China.

Objective. Craniopharyngiomas are the most common parasellar neoplasms in children. Because it is difficult to diagnose subtle visual or endocrinologic changes in young children at an early stage, craniopharyngiomas may grow to a considerable size before diagnosis. Methods. We used transcranial Doppler sonography to diagnose and follow up 5 patients with craniopharyngiomas. There were 3 girls and 2 boys aged from 6 years 4 months to 10 years. Results. The initial manifestations were visual defects (n = 4), headaches (n = 3), and growth restriction (n = 1). One patient had a diagnosis of a craniopharyngioma on the basis of sonography before brain computed tomography. All 5 patients were examined with transcranial color Doppler sonography before surgery and for postoperative follow-up. Sonography showed a cystic component with calcification in 4 patients and a solid component in 1 patient; these findings were compatible with the computed tomographic findings. Displacement of the vessels of the circle of Willis was found. Tumor recurrences were detected early on transcranial sonography in 4 patients at 1 to 8 months' follow-up; these were proved by computed tomography. Conclusions. Transcranial Doppler sonography is a convenient tool for the diagnosis, evaluation, and follow-up of craniopharyngiomas. It can adequately describe vessels around the tumors and show tumor recurrence at an early stage.

Key Words: craniopharyngioma • sonography • transcranial Doppler

Abbreviations: CT, computed tomography • MR, magnetic resonance