A Clinical Analysis of CT-guided Stereotactic Biopsy for Intracranial Mass Lesions

Chang, Jae Chil; Kim, Bum Tae; Choi, Soon Kwan; Shin, Won Han; Byun, Bark Jang

Abstract

Using computed tomographic scanners, stereotactic guided brain biopsy usually permits safe and accurate pathologic diagnosis. In our department between 1991 and 1995, 35 patients underwent CT guided stereotactic biopsy and/or craniotomy with CRW stereotactic frame, and following results were obtained. 1) All lesions were supratentorial. As surgical intervention for the diagnosis, biopsy was carried out in 25(71.4%), aspiration of cystic content was in 2(6%), and stereotactic guided craniotomy was in 8 cases(23%) respectively. 2) A positive diagnosis could be obtained in 34 cases(97.1%), and inconclusive diagnosis disclosed in only one case (2.9%). Positive diagnoses included: 10 cases of astrocytoma(28.6%), 4 cases of glioblastoma(11.4%), metastasis, germinoma, and meningioma in that order. 3) It seemed to be difficcult to ascertain a grade and to search for any presence of mixed area in glioma cases, because open craniotomy was not carried out in all cases. 4) The biosy specimens were generally obtained with cup forceps, however a spiral needle core device with outer probe was very useful for obtaining tissue of tumor for an unavailable case with cup forceps. 5) The immediate post-operative CT scan after 3-4 hours of procedure gave information for accurate site of target under location of air bubble, and any evidence of complication such as hemorrhage. This study provides evidence that CT-guided stereotactic biopsy is a reliable, simple, and safe method for obtaining histological diagnosis of intracranial mass lesions.