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Original Article

J Liaquat Uni Med Health Sci. 2010; 9(2): 64-69


MRI Characterization and Histopathological Correlation of Primary Intra-axial Brain Glioma

Ishtiaq A Chishty, Muhammad Zafar Rafique, Munawar Hussain, Waseem Akhtar, Muhammad Nadeem Ahmed, Zafar Sajjad, Syed Zafar Ali.

Abstract
OBJECTIVE: To determine the diagnostic accuracy of magnetic resonance imaging (MRI) in preoperative
diagnosis and grading of intra-axial gliomas compared with histopathology.
STUDY DESIGN: Prospective, comparative, study.
PLACE AND DURATION OF STUDY: Radiology Department, Aga Khan University Hospital, Karachi
from July 2004 to June 2006.
METHODS: Fifty-three patients having different neurological symptoms referred to Radiology Department
Aga Khan University Hospital for MRI examination were included in the study. These patients
were provisionally diagnosed radiologically having intra-axial brain tumor or subsequently
found to have pathologically proven primary intra-axial brain tumors. MRI scans were
evaluated for location, consistency, hemorrhage, necrosis, margins, edema, MRI signals contrast
enhancement and any additional features for staging the tumor. Preoperative diagnosis
􀁚􀁄􀁖􀀃 􀁆􀁒􀁐􀁓􀁄􀁕􀁈􀁇􀀃 􀁚􀁌􀁗􀁋􀀃 􀁓􀁒􀁖􀁗􀁒􀁓􀁈􀁕􀁄􀁗􀁌􀁙􀁈􀀃 􀁓􀁄􀁗􀁋􀁒􀁏􀁒􀁊􀁌􀁆􀁄􀁏􀀃 􀁇􀁌􀁄􀁊􀁑􀁒􀁖􀁌􀁖􀀃 􀁅􀁜􀀃 􀁘􀁖􀁌􀁑􀁊􀀃 􀀳􀁈􀁄􀁕􀁖􀁒􀁑􀂶􀁖􀀃 􀀦􀁋􀁌􀀃 􀁖􀁔􀁘􀁄􀁕􀁈􀀃 􀁗􀁈􀁖􀁗􀀑􀀃
Accuracy of magnetic resonance imaging in diagnosing and staging the brain tumors was determined.
Sensitivity, specificity, accuracy, positive predictive value and negative predictive
value of MRI in characterizing the lesion was also calculated.
RESULTS: The study included 53 patients with age ranging from 1-year 10-months to 60 years
(mean 32.7 years). Twenty-eight patients had supratentorial tumors (52%) and 25 had infratentorial
tumors (47%). Twenty-eight patients had Astrocytoma (52%), 10 had Oligodendroglioma
(19%), 6 had Medulloblastoma (11%), 5 had Lymphoma (9%), and 4 had Hemangioblastoma
(7%). Preoperative MRI diagnosis was correct in 50 patients with accuracy of 94%. No significant
difference was found between preoperative MRI grading and postoperative histopathological
grade of intra-axial tumor (p-value>0.05). Sensitivity, specificity, positive predictive value
and negative predictive value of MRI in detecting tumor necrosis were 93%, 77%, 80% and 90%
while for detecting tumor hemorrhage were 57%, 93%, 57%, and 93% respectively.
CONCLUSION: MRI is very accurate in preoperative diagnosis, staging and assessing the tumor
characteristics of primary intra-axial brain tumors. It can be used reliably in our usual clinical
practice.

Key words: Glioma, Intra-axial, Brain tumors, MRI, diagnostic accuracy.



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