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Two neuroradiologists independently reviewed preoperative and postoperative MRI. Univariable and multivariable analyses were performed to compare the postoperative cerebellar mutism syndrome (pCMS) and non-pCMS groups. Correlation analysis was performed using the Spearman correlation coefficient analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Of 124 patients, 47 (37.9%) developed pCMS. The median follow-up duration was 45.73 (Q1: 33.4, Q3: 64.0) months. The median duration of mutism was 45 days. The median tumor size was 48.8 (Q1: 42.1, Q3: 56.8) mm. In the univariable analysis, abnormal T2-weighted signal of the left dentate nucleus (DN) (74.5% in the pCMS group vs 36.4% in the non-pCMS group, p &lt; 0.001), right DN (83.0% vs 40.3%, p &lt; 0.001), left superior cerebellar peduncle (SCP) (74.5% vs 27.3%, p &lt; 0.001), right SCP (63.8% vs 23.4%, p &lt; 0.001), left middle cerebellar peduncle (MCP) (51.1% vs 26.0%, p = 0.008), and right MCP (61.7% vs 26.0%, p &lt; 0.001); male sex (83.0% vs 45.5%, p &lt; 0.001); vermis 3 impairment (49.4% vs 19.1%, p = 0.002); solid tumor (91.5% vs 72.7%, p = 0.022); and hydrocephalus (72.3% vs 45.5%, p = 0.006) were more frequent in the pCMS group than in the non-pCMS group. Multivariable logistic analysis showed that male sex (adjusted OR 4.08, p = 0.010) and the cerebro-cerebellar circuit score of T2-weighted images (adjusted OR 2.15, p &lt; 0.001) were independent risk factors for pCMS. The cerebro-cerebellar circuit score positively correlated with the duration of mutism. In Cox regression analysis, the cerebro-cerebellar integrated circuit injury score of T2 (adjusted HR 0.790, 95% CI 0.637\u20130.980; p = 0.032) and injury of vermis 3 (adjusted HR 3.005, 95% CI 1.197\u20137.547; p = 0.019) were independently associated with the duration of mutism.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Male sex and cerebro-cerebellar circuit damage are independent risk factors for pCMS. The cerebro-cerebellar circuit score indicates the duration of mutism.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.8.peds22294","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T07:17:06Z","timestamp":1665213426000},"page":"567-577","source":"Crossref","is-referenced-by-count":4,"title":["Postoperative MRI features of cerebellar mutism syndrome: a retrospective cohort study"],"prefix":"10.3171","volume":"30","author":[{"given":"Wei","family":"Yang","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Radiology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingjie","family":"Cai","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojiao","family":"Peng","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hailang","family":"Sun","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiashu","family":"Chen","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zesheng","family":"Ying","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiyi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan; and"},{"name":"Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Peng","sequence":"additional","affiliation":[{"name":"Radiology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Ge","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1007\/s00381-016-3093-3","article-title":"Consensus paper on post-operative pediatric cerebellar mutism syndrome: the Iceland Delphi results","volume":"32","author":"Gudrunardottir T","year":"2016","unstructured":"Gudrunardottir T, Morgan AT, Lux AL,  Consensus paper on post-operative pediatric cerebellar mutism syndrome: the Iceland Delphi results. 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