Radiological Features and Postoperative Histopathologic Diagnosis of Intracranial Masses at Tikur Anbessa Specialized Hospital and MCM Hospital
AbstractBackground: Intracranial mass lesions are common causes of neurological morbidity and are detectable by cranial imaging. Given the wide range of pathological processes that can present as intracranial mass lesions, the radiologist can limit the differential diagnosis to inform clinical decision-making. The main objective of this review was to analyze radiologic
features and postoperative histopathology diagnosis of intracranial mass lesions.
Methods: A cross sectional study was conducted on 96 patients who underwent surgery for intracranial mass lesions at Tikur Anbessa Specialized Hospital (TASH) and Myungsung Christian Medical Center (MCM) in a period of 3 years (Feb 2009-Dec 2011). Patients were
limited to those who had histopathologic result and either CT (n=67), MRI (n=14) scan report or both (n=15).
Results: Histopathologically confirmed intracranial masses constituted meningioma = 32 (39%), glioma =15 (18.3%), pituitary adenoma = 14 (17%), and tuberculoma = 6 (7.3%).The CT scan sensitivity, specificity, and accuracy in differentiating meningiomas from other intracranial masses, taking the first differential as most likely diagnosis, was 80%, 95% and 88.6% whereas for gliomas it was 71%, 85.7% and 83% respectively. The higher rate of meningiomas found in this study may result from surgeons bias toward preference of resection of extra axial tumors or longer survival of meningioma patients.
Conclusion: Meningiomas were the commonest histologically diagnosed intracranial mass lesions followed by glioma, but their prevalence may have been overestimated in this study because surgeons are more likely to resect them and confirm their diagnosis. Tuberculoma was the commonest non-tumor lesion. CT scan was more accurate, sensitive and specific in diagnosing benign than malignant masses.