Summary
The modern neurodiagnostic techniques of MR imaging, CT scanning and angiography provide valuable morphological information that, although highly sensitive to tumour localisation, still lacks comparable specificity as to the exact histological nature of those lesions demonstrated. Biopsy remains necessary.
To patients with potentially inoperable lesions or lesions best treated by chemotherapy or irradiation, modern techniques of neurosurgery now offer the option of precise stereotactic biopsy through small twist-drill burr holes as opposed to open biopsy. The interrelationships between MR, CT, angiography and stereotactic biopsy and their respective roles in the establishment of a definitive diagnosis are discussed.
Similar content being viewed by others
References
Balériaux D, Michelozzi G (1990) Tumors of the posterior fossa. In: Huk WJ, Gademann G, Friedmann G (eds) MRI of central nervous system diseases. Springer, Berlin Heidelberg New York Tokyo, pp 277–296
Brant-Zawadzki M, Badami JP, Mille CM,et al (1984) Primary intracranial tumor imaging: a comparison of magnetic resonance and CT. Radiology 150: 435–440
Ball WS Jr, Towbin RB (1989) MRI of pediatric central nervous system neoplasms. In: Pomeranz SJ (ed) Craniospinal magnetic resonance imaging. Saunders, Philadelphia, pp 177–207
Barkovich AJ, Edwards MSB (1990) Brain tumors of childhood. In: Barkovich AJ (ed) Pediatric neuroimaging. Raven, New York, pp 149–203
Boulin A (1988) Tumeurs intracrâniennes. In: Vignaud J, Boulin A (eds) Tomodensitométrie crânio-encéphalique. Vigot, Paris, pp 266–367
Chamberlain MC, Murovic JA, Levin VA (1988) Absence of contrast enhancement on CT brain scans of patients with supratentorial malignant gliomas. Neurology 38: 1371–1374
Cohadon F (1989) Tumeurs du système nerveux et de ses enveloppes. In: Cohadon F (ed) Encyclopédie des cancers. Flammarion Médecine-Sciences, Paris, pp 818
Daumas-Duport C, Scheithauer BW, Kelly P (1987) A histologic and cytologic method for the spatial definition of gliomas. Mayo Clin Proc 62: 435–449
Dean BL, Drayer BP, Bird CR, Flom RA, Hodak JA, Coons SW, Carey RG (1990) Gliomas: classification with MR imaging. Radiology 174: 411–415
Earnest FIV, Kelly PJ, Scheitauer BW,et al (1988) Cerebral astrocytomas: histopathologic correlation of MR and CT contrast enhancement with stereotactic biopsy. Radiology 166: 823–827
Hasso AN, Fahmy JL, Hinshaw DB (1988) Tumours of the posterior fossa. In: Stark DD, Brandley WG Jr (eds) Magnetic resonance imaging. Mosby, St. Louis, pp 425–450
Higer HP, Just M (1989) MR-Atlas der Hirntumore. Diagnostik und Nachsorge. Thieme, Stuttgart, p 204
Huk WJ, Heindel W (1990) Intracranial tumors. In: Huk WJ Gademann G, Friedmann G (eds) MRI of central nervous system diseases, pp 229–275
Johnson PC, Hunt SJ, Drayer BP (1989) Human cerebral gliomas: correlation of postmortem MR imaging and neuropathologic findings. Radiology 170: 211–217
Kazner E, Wende S, Grumme T, Stochdorph O, Felix R, Claussen C (1989) Computed tomography and magnetic resonance tomography of intracranial tumors. A clinical perspective.
Keith E, Kortman E, Bradley WG (1988) Supratentorial neoplasms. In: Stark DD, Brandley WG Jr (eds) Magnetic resonance imaging. Mosby, St. Louis, pp 375–422
Kernohan JW, Sayre GP (1972) Tumors of the central nervous system. Atlas of tumor pathology, Section 10, Fasc 35. Armed Forces Institute of Pathology, Washington DC, p 400
Lee Y, Van Tassel P (1989) Intracranial oligodendrogliomas: imaging findings in 35 untreated cases. AJNR 10: 119–127
Lee Y, Van Tassel P, Bruner JM, Moser RP, Share JC (1989) Juvenile pilocytic astrocytomas: CT and MR characteristics. AJNR 10: 363–370
Masaryk TJ, Modic MT, Ross JS,et al (1989) Intracranial circulation: preliminary clinical results with three-dimensional (volume) MR angiography. Radiology 171: 793–799
Pomeranz SJ (1989) Posterior fossa, skull base, craniocervical junction. In: Pomeranz SJ (ed) Craniospinal magnetic resonance imaging. Saunders, Philadelphia, pp 248–274
Poncelet B, Baleriaux D, Grand C, Van Dyk P, Degraaf R, Segebarth C (1990) MR inflow angiography for the evaluation of dural sinus patency (abstract). Radiology 177: 257
Rubinstein LJ (1972) Tumors of the central nervous system. In: Rubinstein LJ (ed) Atlas of tumor pathology, 2 nd Series, Fasc 6. Armed Forces Institute of Pathology, Washington DC, pp 160–198
Russel DS, Rubinstein LJ (1989) Pathology of tumours of the nervous system, 5th Ed. Edward Arnold, London, pp 1012
Segebarth CM, Baleriaux DF, Luyten PR, Den Hollander JA (1990) Detection of metabolic heterogeneity of human intracranial tumors in Vivo by1H NMR spectroscopic imaging. Magn Reson Med 13: 62–76
Schorner W, Laniado M, Kornmesser W, Felix R (1989) Comparison of multi echo and contrast-enhanced MR scans: image contrast and delineation of intracranial tumors. Neuroradiology 31: 140–147
Zülch KJ (1986) Brain tumors: their histology and pathology, 3rd Ed. Springer, Berlin Heidelberg New York Tokyo, p 261
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Balériaux, D., Parizel, P.M., Matos, C. et al. Stereotactic indications for neuroradiological differential diagnosis. Acta neurochir 124, 31–33 (1993). https://doi.org/10.1007/BF01400712
Issue Date:
DOI: https://doi.org/10.1007/BF01400712