Postoperative pediatric cerebellar mutism syndrome (pCMS), characterized mainly by delayed onset transient mutism is a poorly understood complication that may occur after pediatric medulloblastoma (MB) resection. Our aim was to investigate postoperative changes in whole-brain cerebral blood flow (CBF) at rest in pCMS patients using arterial spin labeling (ASL) perfusion imaging. This study compared preoperative and postoperative T2-weighted signal abnormalities and CBF using a voxel-wise, whole-brain analysis in 27 children undergoing MB resection, including 11 patients who developed mutism and 16 who did not. Comparison of postoperative T2 signal abnormalities between patients who developed pCMS (mean age 7.0 years) and those who did not showed that pCMS (mean age 8.9 years) patients were significantly more likely to present with T2-weighted hyperintensities in the right dentate nucleus (DN) (p = 0.02). Comparison of preoperative and postoperative CBF in patients with pCMS showed a significant postoperative CBF decrease in the left pre-supplementary motor area (pre-SMA) (p = 0.007) and SMA (p = 0.009). In patients who did not develop pCMS, no significant differences were observed. Findings provide evidence of an association between pCMS, injury to the right DN, and left pre-SMA/SMA hypoperfusion, areas responsible for speech. This supports the relevance of CBF investigations in pCMS.

术后小儿小脑缄默症综合征 (pCMS) 的主要特征是迟发性短暂性缄默症，这是一种鲜为人知的并发症，可能发生在小儿髓母细胞瘤 (MB) 切除术后。我们的目的是使用动脉自旋标记 (ASL) 灌注成像研究 pCMS 患者静息时全脑脑血流量 (CBF) 的术后变化。本研究使用体素全脑分析比较了 27 名接受 MB 切除术的儿童的术前和术后 T2 加权信号异常和 CBF，其中包括 11 名发生缄默症和 16 名未发生缄默症的患者。发生 pCMS（平均年龄 7.0 岁）和未发生 pCMS（平均年龄 8.0 岁）的患者术后 T2 信号异常的比较。9 年）患者明显更有可能出现右齿状核 (DN) 的 T2 加权高信号（p = 0.02）。pCMS 患者术前和术后 CBF 的比较显示，左侧辅助前运动区 (pre-SMA) (p = 0.007) 和 SMA (p = 0.009) 术后 CBF 显着降低。在未发生 pCMS 的患者中，未观察到显着差异。研究结果提供了 pCMS、右侧 DN 损伤和左侧前 SMA/SMA 低灌注（负责言语的区域）之间关联的证据。这支持了 pCMS 中 CBF 调查的相关性。pCMS 患者术前和术后 CBF 的比较显示，左侧辅助前运动区 (pre-SMA) (p = 0.007) 和 SMA (p = 0.009) 术后 CBF 显着降低。在未发生 pCMS 的患者中，未观察到显着差异。研究结果提供了 pCMS、右侧 DN 损伤和左侧前 SMA/SMA 低灌注（负责言语的区域）之间关联的证据。这支持了 pCMS 中 CBF 调查的相关性。pCMS 患者术前和术后 CBF 的比较显示，左侧辅助前运动区 (pre-SMA) (p = 0.007) 和 SMA (p = 0.009) 术后 CBF 显着降低。在未发生 pCMS 的患者中，未观察到显着差异。研究结果提供了 pCMS、右侧 DN 损伤和左侧前 SMA/SMA 低灌注（负责言语的区域）之间关联的证据。这支持了 pCMS 中 CBF 调查的相关性。