T. Hagen et al., CORRELATION OF PREOPERATIVE NEURORADIOLOG ICAL DIAGNOSIS WITH POSTOPERATIVE HISTOLOGICAL DIAGNOSIS IN PATHOLOGICAL INTRACRANIAL PROCESSES, Radiologe, 35(11), 1995, pp. 808-815
Purpose: To determine the accuracy of preoperative neuroradiological d
iagnosis of pathological intracranial processes in a prospective study
. Material and Method: A team of three neuroradiologists determined th
e diagnosis in CT, MR and angiography prior to stereotactic biopsy or
operative resection (173 patients). Only one diagnosis was allowed, ex
cept in those cases with two equally probable diagnosis (24 patients).
In 106 patients a resection of a brain tumor, in 67 cases a stereotac
tic biopsy was performed. According to the histological diagnosis the
patients were subdivided into three groups: 1: complete agreement: the
single diagnosis was correct. 2: conditional agreement: one of the 2
differential diagnosis was correct. 3: no agreement Results: In 131 ca
ses (76 %) a com plete agreement, in 24 cases (14%) a conditional agre
ement and in 18 patients (10 %) no agreement were found. Assuming only
stereotactic procedures the neuroradiological diagnosis was correct i
n 44 cases (66 %) and incorrect in 10 cases (15 %). In 13 patients (19
%) one of the two differential diagnosis was correct. The specificity
of the major tumors was calculated between 92 % and 100 %. The sensit
ivity for pituitary adenomas (n = 9) and neurinomas (n = 11) was 100 %
, the sensitivity for meningiomas (n = 32) was 94 %. A sensitivity was
calculated between 50 % and 71 % for astrocytomas (WHO I to WHO IV, n
= 64) and metastases (n = 24). Conclusion: The accuracy was found to
be higher than in the comparable retrospective studies.