Stereotactic Biopsy Diagnosis And Treatment For Complex Brain Diseases

Objective: To estimate the role of the calculation “cranium point and3D Long Axis inone line” in stereotactic biopsy for complex brain diseases diagnosis and treatment withretrospective analysis, in order to increase the positive incidence and prevent the side-effectin brain diseases biopsy.Method:26patients (included16male and10female) with complex brain diseasewere undergone brain stereotactic biopsy with “cranium point and3D Long Axis in one line”between June2004and December2011. Age of patients was from16to73years, mean agewas45.7years. All patients underwent CT and MRI examination, and3of them underwentmagnetic resonance spectroscopy (MRS) to detect the peak value and ratio changes ofN-acetyl aspartate (NAA), creatine (Cr), Choline (Cho), Lip(lipid) and Lactate(Lac. Beforebiopsy, we gained the3D shape of the lesion image by CT combined with MRI. Then,using the calculation of “cranium point and3D Long Axis in one line” to get the3D longaxis of skull entering point, two aplical points of lesion and the center point of lesion. Get tsamples of the lesion.Stereotactic biopsy samples were treated with HE andImmunochemical staining methods.1of the26patients underwent a routine stereotactic32Pisotope radiotherapy surgery,4cases underwent cyst fluid aspiration (including1brain stemcystic glioma,1multiple tumor,1brain abscess and1metastatic carcinoma). Malignantlesions given radiotherapy and chemotherapy.The benign lesions were given postoperativelysymptomatic treatment.Result: From the imaging detection,8of the26patients were multiple occupyinglesions,8of them implicated multi-lobes of the brain, and the rest of them are all singleirregular lesions without significant enhancement and specific signs in MRI image. Theresults from3patients underwent MRS examination, showed changes in Cho, NAA, Cho/Crand NAA/Cr. After biopsy, All patients got clear pathological diagnosis, includinggliomatosis cerebri, cerebral tuberculoma, multicentric gliomas, multicentric malignancy,tentorium of cerebellum medulloblastoma ismetastatic, intracerebral internal capsule,thalamencephalon astrocytic glioma, cerebral infarction, metastatic adenocarcinoma,etc.Only1patient hemorrhaged about15ml in CT scan reexamine, but without obviousadverse symptoms, and recovered after conservative treatment.26patients in this group werenot infected or death. All of the26patients were followed up,18cases of malignant patients with survival time from6months to4years, one case of cystic glioma of the pons to survivefour years,is still under follow-up. Non-neoplastic lesions were followed up for a goodrecovery.Conclusion: The results suggested that the calculation of “cranium point and3D LongAxis in one line” was a safe and reliable method with high positive rate and low incidencerate of side-effect in brain stereotactic biopsy In addition,32P isotope radiation therapy understereotactic could inhibit tumor growth. Pumping fluid therapy for cystic gliomas and brainabscess could achieve unambiguous c therapeutic effect. Also, MRS played a unique rolein the differential diagnosis of intracranial lesions, as it could provide an important referencefor stereotactic biopsy, and help to choose the targets and improve the positive biopsy rate.Especially for confirming the lesions which diffuse, deep and multiple in functional area ofbrain.It was also useful for follow-up treatment, and could reduce the economic burden ofpatients, and improve patient’s quality of life.