Stereotactic Biopsy For Multiple Intracranial Lesions And Comparison Between Biopsy Pathology And MRS Diagnoses

Objective: By compare stereotactic biopsy and MRI examination results combined with MRS diagnosis of intracranial multiple lesions. Contrast consistency pathological diagnosis and imaging preoperative diagnosis. To investigate the neural image-guided stereotactic biopsy obtained histopathologic diagnosis accuracy and reliability, to clarify the meaning of intracranial stereotactic biopsy in the diagnosis of multiple lesions.Methods: A retrospective analysis of 37 patients underwent stereotactic biopsy in cases of multiple intracranial lesions. There were 21 males(56.7%) and 16 females(43.2%), aged 20-70 years(mean 53.5 years). These patients determined target of biopsy and biopsy methods based on imaging manifestations when completed the MRI and MRS examinations. According imaging to determine the target biopsy and biopsy ways in which line has framework stereotactic biopsy in 22 cases, frameless neuronavigation directed biopsy in 15 cases. To make a comparative analysis of preoperative MRI combined with MRS imaging diagnosis and stereotactic biopsy pathological diagnosis, and finishing the list to visually indicate that the difference of the both qualitative diagnosis of multiple intracranial lesions.Results: The group of 37 cases, preoperative MRI combined with MRS diagnosis: low-grade gliomas in 17 cases, 8 cases of high-grade glioma, 2 cases of lymphomas, 2 cases of demyelination, 5 cases of inflammation, 3 cases of metastatic carcinoma. Pathological diagnosis: 19 cases of low-grade gliomas, 8 cases of high-grade gliomas,3 cases of lymphomas, 3 cases of demyelination, 2 cases of inflammatory lesions, 2 cases of metastatic carcinoma. Pathological diagnosis and MRS diagnosis coincidence rate was 83.7%(31/37), no coincidence rate was 16.2%(6/37). Three cases of low-grade gliomas misdiagnosed as inflammatory lesions, 1 case was misdiagnosed as multiple demyelination as low grade gliomas, one case of lymphomas misdiagnosed as high-grade gliomas, one case of high-grade gliomas misdiagnosed as metastatic cancer. All the cases were obtained the pathological diagnosis, postoperative epilepsy in 1 case, biopsy targets a small amount of hemorrhage in 1 case, no death and serious complications.Conclusion: MRI combined with MRS examinations with high accuracy in the diagnosis of multiple intracranial lesions, but there is still a certain misdiagnosis rate. There are certainly guiding value with the metabolic changes of MRS in biopsy target selection. Stereotactic biopsy is minimally invasive, safe, decisive significance in the diagnosis of multiple lesions in the intracranial, is worthy of wider application.