Correlation between histopathology and radiological findings by Computed Tomography (CT) scan of intracranial masses in Kenyatta National Hospital (KNH

Abstract

Intracranial masses are a fairly common neurologic problem in our set up. CT scan has a proven ability in the diagnosis of intracranial masses. With CT scan one can precisely know the tumour location and to some extent the tumour type by studying the biological characteristics of these masses. However, histological studies offer the most accepted mode of establishing diagnosis. Different brain masses exhibit similar (CT) radiological features, a property that may pose some difficulties to the reporting radiologist. To show these difficulties a correlative study between CT scan findings and histological findings of various brain masses was done. A total of 150 cases with both CT Scan reports and histopathological reports after brain surgery were collected for this study. There were 84 (56%) males and 66 (44%) females giving a M:F ratio of 1.27: 1. The age of patients ranged from 8 days to 72 years. Most of the patients 123 (82%) had clinical information indicated by the clinician, however 27 (18%) cases no clinical data was available. The commonest clinical presentation with which the patients presented with are associated with increased intracranial. pressure and these were headaches 109 (87.2%), visual disturbance 65(52%), seizures 31(24.8%) and locomotor system malfunction 71(56.8%). The four commonest intra cranial masses were gliomas 54(36%), meningiomas 21 (14%), Medulloblastoma 12 (8.7%) and tuberculoma 12 (8.0%). Patterns of enhancement in various intracranial masses after IV contrast administration are discussed. The two brain geographical regions where most of these masses were located are parietal and posterior cranial fossa. CT scan reliability in diagnosing intra cranial masses is discussed on the basis of radiological - histological diagnosis agreement. It is hoped that the results of this study will increase the already existing confidence in the use of CT scan in diagnosis of brain masses by the referring clinicians. AIM To determine (CT) radiological and histological diagnosis agreement of intracranial masses. Specific objectives: 1. Distribution of intracranial tumours by anatomic region and type. 2. To determine the frequency of the commonest histologically confirmed intracranial masses. 3. To study the patterns of enhancement after intravenous (IV) contrast medium administration. 4. To study the age; sex distribution of intracranial masses. 5. To study the clinical presentation of intra cranial masses and the final outcome.