| Objective: By literature review,the clinical and imaging features of intracranial dermoid cysts were summarized as to investigate the sex difference and rupture related factors of intracranial dermoid cysts.Methods: We searched the Cochrane Library,Pubmed,Embase,CNKI,Wanfang data,CBMand VIP database,and collected the literatures about intracranial dermoid cysts(IDC)published from the start of the database to September 2016.The two evaluators independently screened the literatures according to pre-established inclusion and exclusion criteria.The data from the literatures were extracted and analyzed statistically,including date of publication,the first author’s name,the patient’s gender,age,course of disease,clinical manifestations,imaging findings,location of the lesion,rupture or not,accompanying disease,complications,treatment and malignance.Results: A total of 1846 related literatures were retrieved and 138 literatures were selected.Only 1~3 cases were reported in each article,and altogether 152 patients were enrolled,including 76 female patients and 76 male patients.The differences were not statistically significant in the different gender patients in age of diagnosis(MD=-4.77,95%CI[-10.72,1.17],t=-1.59,P =0.1148),course of disease(c2=1.7182,(49)=0.7874),lesion location(c2=1.4757,(49)=0.2244),the initial Clinical presentation(c2=0.9877,(49)=0.6103),CT(c2=0.6310,(49)=0.4270),T1WI(c2=0.0290,(49)=0.8648),T2 WI(c2=2.740,(49)=0.1638),incidence of rupture(c2=0.2440,(49)=0.6213),dermal sinus or occipital mass(c2=1.1176,(49)=0.8029),hydrocephalus(c2=2.6579,(49)=0.1030),intracranial infection(c2=0.3619,(49)=0.5475).The average age of diagnosis of IDC was(29.86±18.65)years old.65.13% of the patients had a course of more than a month.More than half of the patients had a headache and 15.79% of patients started with epilepsy.67.76% of the lesions were located on the supratentorial.And nearly 90% of the patients showed low density on the CT.About 70% of the patients showed hyperintense signal on T1 WI and 90% of the patients were hypointense/isointense on T2 WI.The incidence of cyst rupture was about 40%.The incidence of dermal sinus or occipital mass,hydrocephalus and intracranial infection was 10.53%,21.05%,7.89% respectively.There were 139 patients who were selected for surgical treatment,and 13 patients received non-operative treatment.Malignant transformation was squamous cell carcinoma in 4 male patients.And 3 female patients died.A univariable analysis showed those as T1WI(c2=12.5295,(49)=0.0004),T2WI(c2=6.2152,(49)=0.0126),course of disease(c2=15.3912,(49)=0.0001),location of the lesion(c2=18.8030,(49)=0.0000),age of diagnosis(MD=6.38,95%CI[0.38,12.38],t=2.10,P =0.0372)were associated with the risk of rupture of the cyst,but the initial clinical presentation was not(c2=0.9877,(49)=0.6103).Logistic regression analysis found that the course of the disease(OR=1.3988),location of the lesion(OR=4.2889)and T1 WI signal(OR=3.0938)were independent risk factors for the rupture of cysts.Conclusion:(1).Intracranial dermoid cysts have no gender differences in age of diagnosis,course of disease,lesion location,the initial clinical presentation,incidence of rupture,CT density,T1 WI,T2 WI,concomitant disease,complications and malignance.(2).The peak age of IDC incidence is about 30 years old,mostpatients had a headache or epilepsy,and lesions often located on the supratentorial.Most of lesionswere low density on CT.And most of them were high signal on T1 WI and T2 WI.The treatment is mainly performed with surgical treatment,and malignant transformation is rare.(3).The course of several hours,the lesion located on the supratentorial and hyperintensity in T1 WI were the independent risk factors for the cyst rupture of the IDC. |
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