Diagnostic Value Of Stereotactic Biopsy In Intracranial Lesions Without Enhancement Effect

Objective: By comparing the result of the without enhancement lesions diagnosticanalysis of stereotactic biopsy with MRI scanning. To investigate the value, reliabilityand accuracy of stereotactic biopsy for the questionable intracranial lesions had noenhancement effect.Methods: Stereotactic biopsy was performed from August2000to March2011in47patients,47patients with intracranial lesions in the enhanced MR scan showed noobvious enhancement, imaging diagnosis is very difficult. There were29males (61.7%)and18females (38.3%). The patients were aged between11and73(mean42.5) years.A framework for MR-guided stereotactic biopsy in38cases, frameless neuronavigationdirected biopsy in9cases. In order to clarify whether the samples taken from diseasedtissue, the biopsy specimens were underwent pathological examination of intraoperativerapid frozen, routine pathological examination was performed after surgery. Theimmunohistochemical staining of the histopathological section of the specimens wereperformed if necessary. To make a comparative analysis of preoperative MRI findingsand stereotactic biopsy pathological diagnosis, and finishing the list to visually indicatethat the difference of the both qualitative diagnosis between unenhanced lesions in theintracranial.Results: The47cases, preoperative MRI examinations showed the total of19cases ofbenign lesions or non-neoplastic lesions include of demyelination, inflammatory disease,cerebral infarction, cerebral radionecrosis. The remaining28cases were considered for the proliferation of glial cells, low-grade gliomas, central neurocytomas, bad embryonicdevelopment neuroepithelial tumors and other intracranial neoplastic lesions.42patients received a clear pathological diagnosis, and another5patients without adefinite pathological diagnosis, the positive rate of pathological diagnosis was42/47(89.4%).19cases of benign lesions or non-neoplastic lesions, five cases toconsider low-grade gliomas after biopsy,3cases to consider the proliferation of glialcells, two cases for cerebral infarction in patients with biopsy confirmed inflammatorydisease,28cases of diagnostic imaging to consider intracranial tumor lesions,six casesof pathologically diagnosed as demyelination,5cases diagnosed as inflammatorylesions, pathological comply with cerebral infarction, two cases to considerdysembryoplastic neuroepithelial tumor after biopsy pathologically confirmed asastrocytoma grade â… -â…¡.Non-neoplastic lesions of the brain, the coincidence rate ofMRI and pathological diagnosis is9/19(47.4%), the diagnosis of tumor lesions was14/28(50.0%).The puncture tract bleeding in1case (2.1%) after biopsy, bleeding wascured after a week. No patients died from the stereotactic biopsy.Conclusions: Stereotactic biopsy is an invasive, reliable and good method to diagnosethe questionable intracranial lesions, especially for the qualitative diagnosis of difficultlesions had no significant enhancement in the enhanced MRI scans.