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Correlation Between MRI Findings and Histological Diagnosis of Brainstem Glioma

Published online by Cambridge University Press:  23 September 2014

Luxin Yin  and
Liwei Zhang
Luxin Yin
Affiliation:
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China
Liwei Zhang*
Affiliation:
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China
*
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, TiantanXili 6, Chongwen District, Beijing, 100050, PR China. Email: [email protected].
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Abstract

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Objective:

In most studies, treatment decisions of brainstem glioma are based solely on MRI features and do not incorporate a histopathological diagnosis. In the current study, we sought to compare MRI characteristics with histopathological findings of bainstem glioma.

Methods:

From April 2003 through April 2012, 150 patients were diagnosed with brainstem gliomas by MRI and microsurgically treated in Tiantan Hospital, Beijing, China. All the MRI and histopathological findings of these patients were respectively reviewed.

Results:

Of the 150 patients, 65 were female and 85 were male, 120 were adults and 30 were children (age < 18 years), 108 were low-grade glioma (72.0%), 35 were high-grade glioma (23.3%). The accuracy of the MRI diagnosis for brainstem glioma was 95.3%. Data analysis of the MRI findings revealed that a focal lesion was associated with a more favorable histopathological diagnosis in intrinsic (P=0.005) and exophytic (P=0.001) brainstem glioma patients. In the intrinsic diffuse type, tumors without enhancement had more favorable pathological findings (P=0.009).

Conclusions:

To our knowledge, this is the largest case series of this nature reported in the literature to date. The results of this study suggest that MRI features of brainstem gliomas could predict some pathological features and guide prognosis, choice of biopsy and treatment modalities. The pathology of tumors with a focal appearance on MRI was associated with a prognosis that was significantly better than their diffuse counterparts. For the intrinsic diffuse gliomas, non-enhancing tumors had pathology suggestive of a favorable prognosis.

Résumé:

Résumé:Objectif:

Dans la plupart des études, les décisions de traitement des gliomes du tronc cérébral sont fondées uniquement sur les caractéristiques de la tumeur à l'IRM et n'incluent pas le diagnostic anatomopathologique. Dans cette étude, nous avons comparé les caractéristiques de gliomes du tronc cérébral à l'IRM avec les constatations anatomopathologiques au moment de la chirurgie.

Méthode:

Un diagnostic de gliome du tronc cérébral a été posé à l'IRM chez 150 patients entre avril 2003 et avril 2012 et ils ont été traités à l'Hôpital Tiantan, à Beijing, en Chine. Nous avons revu toutes les constatations faites à l'IRM et en anatomopathologie chez ces patients.

Résultats:

Parmi les 150 patients, 65 étaient des femmes et 85 étaient des hommes, 120 étaient des adultes et 30 étaient des enfants de moins de 18 ans, et 108 étaient porteurs de gliomes de bas grade de malignité (70,0%) et 35 étaient porteurs de gliomes de haut grade de malignité (23,3%). L'exactitude du diagnostic de gliome du tronc cérébral à l'IRM était de 95,3%. L'analyse des constatations faites à l'IRM a montré qu'une lésion focale était associée à un diagnostic anatomopathologique plus favorable chez les patients atteints de gliomes du tronc cérébral intrinsèques (p = 0,005) et exophytiques (p = 0,001). Parmi les tumeurs intrinsèques de type diffus, les tumeurs sans rehaussement avaient des caractéristiques anatomopathologiques plus favorables (p = 0,009).

Conclusions:

À notre connaissance, ceci constitue la plus grande série de cas de cette nature rapportée dans la littérature à ce jour. Selon les résultats de cette étude, les caractéristiques des gliomes du tronc cérébral à l'IRM pourraient prédire certaines caractéristiques anatomopathologiques et guider le pronostic, le choix de biopsie et les modalités de traitement. La pathologie des tumeurs ayant un aspect focal à l'IRM était significativement meilleure que celle des tumeurs dont l'aspect était diffus. Dans le cas des gliomes diffus intrinsèques, les tumeurs non rehaussantes avaient des caractéristiques anatomopathologiques plus favorables.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 3 , May 2013 , pp. 348 - 354
Copyright
Copyright © The Canadian Journal of Neurological 2013

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