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Erschienen in: Child's Nervous System 12/2011

01.12.2011 | Original Paper

Computed tomography-guided stereotactic biopsy of intracranial lesions in pediatric patients

verfasst von: Ali Meshkini, Sohrab Shahzadi, Alireza Zali, Khosro Parsa, Aimaz Afrough, Amir Hamdi

Erschienen in: Child's Nervous System | Ausgabe 12/2011

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Abstract

Purpose

The primary objective of this study was to report the results of author’s 18-year experience of diagnostic stereotactic biopsy procedures in children with intracranial lesions.

Methods and materials

A retrospective analysis was conducted on stereotactic procedures performed on children with brain tumor between 1989 and 2007.

Results

Stereotactic biopsy of intracranial tumors was performed in 172 children (69 girls, and 103 boys) with the mean age of 9.17 ± 3.66 years at the time of diagnosis. The most frequent anatomical location of lesions was brainstem (45.9%). Glioma was the most common diagnosis, represented in 90.7% of patients (156 patients). Other diagnosed tumors (4.7%) were classified as metastatic (1.7%), lymphomas (1.2%), oligodendroglioma (0.6%), craniopharyngioma (0.6%), and pineocytoma (0.6%). Nonneoplastic lesions were revealed in 4.7% of patients.

Conclusion

The most frequent brain pathology of children is glioma, but the incidence of brain lesions other than gliomas and the frequency of brain lesions in the inoperable areas are compelling reasons to establish tissue diagnosis.
Literatur
4.
Zurück zum Zitat Friedman WA, Sceats DJ Jr, Nestok BR, Ballinger WE Jr (1989) The incidence of unexpected pathological findings in an image-guided biopsy series: a review of 100 consecutive cases. Neurosurgery 25(2):180–184PubMedCrossRef Friedman WA, Sceats DJ Jr, Nestok BR, Ballinger WE Jr (1989) The incidence of unexpected pathological findings in an image-guided biopsy series: a review of 100 consecutive cases. Neurosurgery 25(2):180–184PubMedCrossRef
5.
Zurück zum Zitat Lobato RD, Rivas JJ, Cabello A, Roger R (1982) Stereotactic biopsy of brain lesions visualized with computed tomography. Appl Neurophysiol 45(4–5):426–430PubMed Lobato RD, Rivas JJ, Cabello A, Roger R (1982) Stereotactic biopsy of brain lesions visualized with computed tomography. Appl Neurophysiol 45(4–5):426–430PubMed
6.
Zurück zum Zitat Schumacher M, Schulte-Monting J, Stoeter P, Warmuth-Metz M, Solymosi L (2007) Magnetic resonance imaging compared with biopsy in the diagnosis of brainstem diseases of childhood: a multicenter review. J Neurosurg 106(2 Suppl):111–119. doi:10.3171/ped.2007.106.2.111 PubMed Schumacher M, Schulte-Monting J, Stoeter P, Warmuth-Metz M, Solymosi L (2007) Magnetic resonance imaging compared with biopsy in the diagnosis of brainstem diseases of childhood: a multicenter review. J Neurosurg 106(2 Suppl):111–119. doi:10.​3171/​ped.​2007.​106.​2.​111 PubMed
7.
Zurück zum Zitat Wild AM, Xuereb JH, Marks PV, Gleave JR (1990) Computerized tomographic stereotaxy in the management of 200 consecutive intracranial mass lesions. Analysis of indications, benefits and outcome. Br J Neurosurg 4(5):407–415PubMedCrossRef Wild AM, Xuereb JH, Marks PV, Gleave JR (1990) Computerized tomographic stereotaxy in the management of 200 consecutive intracranial mass lesions. Analysis of indications, benefits and outcome. Br J Neurosurg 4(5):407–415PubMedCrossRef
9.
Zurück zum Zitat Gomez H, Barnett GH, Estes ML, Palmer J, Magdinec M (1993) Stereotactic and computer-assisted neurosurgery at the Cleveland Clinic: review of 501 consecutive cases. Cleve Clin J Med 60(5):399–410PubMed Gomez H, Barnett GH, Estes ML, Palmer J, Magdinec M (1993) Stereotactic and computer-assisted neurosurgery at the Cleveland Clinic: review of 501 consecutive cases. Cleve Clin J Med 60(5):399–410PubMed
11.
Zurück zum Zitat Lunsford LD, Coffey RJ, Cojocaru T, Leksell D (1990) Image-guided stereotactic surgery: a 10-year evolutionary experience. Stereotact Funct Neurosurg 54–55:375–387PubMedCrossRef Lunsford LD, Coffey RJ, Cojocaru T, Leksell D (1990) Image-guided stereotactic surgery: a 10-year evolutionary experience. Stereotact Funct Neurosurg 54–55:375–387PubMedCrossRef
13.
Zurück zum Zitat Gleason CA, Wise BL, Feinstein B (1978) Stereotactic localization (with computerized tomographic scanning), biopsy, and radiofrequency treatment of deep brain lesions. Neurosurgery 2(3):217–222PubMedCrossRef Gleason CA, Wise BL, Feinstein B (1978) Stereotactic localization (with computerized tomographic scanning), biopsy, and radiofrequency treatment of deep brain lesions. Neurosurgery 2(3):217–222PubMedCrossRef
15.
Zurück zum Zitat Broggi G, Franzini A, Migliavacca F, Allegranza A (1983) Stereotactic biopsy of deep brain tumors in infancy and childhood. Childs Brain 10(2):92–98PubMed Broggi G, Franzini A, Migliavacca F, Allegranza A (1983) Stereotactic biopsy of deep brain tumors in infancy and childhood. Childs Brain 10(2):92–98PubMed
16.
Zurück zum Zitat Colombo F, Casentini L, Zanusso M, Danieli D, Benedetti A (1988) Validity of stereotactic biopsy as a diagnostic tool. Acta Neurochir Suppl (Wien) 42:152–156 Colombo F, Casentini L, Zanusso M, Danieli D, Benedetti A (1988) Validity of stereotactic biopsy as a diagnostic tool. Acta Neurochir Suppl (Wien) 42:152–156
17.
Zurück zum Zitat Kreth FW, Muacevic A, Medele R, Bise K, Meyer T, Reulen HJ (2001) The risk of haemorrhage after image guided stereotactic biopsy of intra-axial brain tumours—a prospective study. Acta Neurochir (Wien) 143(6):539–545, discussion 545–536CrossRef Kreth FW, Muacevic A, Medele R, Bise K, Meyer T, Reulen HJ (2001) The risk of haemorrhage after image guided stereotactic biopsy of intra-axial brain tumours—a prospective study. Acta Neurochir (Wien) 143(6):539–545, discussion 545–536CrossRef
18.
Zurück zum Zitat Lee T, Kenny BG, Hitchock ER, Teddy PJ, Palividas H, Harkness W, Meyer CH (1991) Supratentorial masses: stereotactic or freehand biopsy? Br J Neurosurg 5(4):331–338PubMedCrossRef Lee T, Kenny BG, Hitchock ER, Teddy PJ, Palividas H, Harkness W, Meyer CH (1991) Supratentorial masses: stereotactic or freehand biopsy? Br J Neurosurg 5(4):331–338PubMedCrossRef
20.
Zurück zum Zitat Voges J, Schroder R, Treuer H, Pastyr O, Schlegel W, Lorenz WJ, Sturm V (1993) CT-guided and computer assisted stereotactic biopsy. Technique, results, indications. Acta Neurochir (Wien) 125(1–4):142–149CrossRef Voges J, Schroder R, Treuer H, Pastyr O, Schlegel W, Lorenz WJ, Sturm V (1993) CT-guided and computer assisted stereotactic biopsy. Technique, results, indications. Acta Neurochir (Wien) 125(1–4):142–149CrossRef
21.
Zurück zum Zitat Wen DY, Hall WA, Miller DA, Seljeskog EL, Maxwell RE (1993) Targeted brain biopsy: a comparison of freehand computed tomography-guided and stereotactic techniques. Neurosurgery 32(3):407–412, discussion 412–403PubMedCrossRef Wen DY, Hall WA, Miller DA, Seljeskog EL, Maxwell RE (1993) Targeted brain biopsy: a comparison of freehand computed tomography-guided and stereotactic techniques. Neurosurgery 32(3):407–412, discussion 412–403PubMedCrossRef
22.
Zurück zum Zitat Yu X, Liu Z, Tian Z, Li S, Huang H, Xiu B, Zhao Q, Liu L, Jing W (2000) Stereotactic biopsy for intracranial space-occupying lesions: clinical analysis of 550 cases. Stereotact Funct Neurosurg 75(2–3):103–108PubMedCrossRef Yu X, Liu Z, Tian Z, Li S, Huang H, Xiu B, Zhao Q, Liu L, Jing W (2000) Stereotactic biopsy for intracranial space-occupying lesions: clinical analysis of 550 cases. Stereotact Funct Neurosurg 75(2–3):103–108PubMedCrossRef
23.
Zurück zum Zitat Apuzzo ML, Chandrasoma PT, Cohen D, Zee CS, Zelman V (1987) Computed imaging stereotaxy: experience and perspective related to 500 procedures applied to brain masses. Neurosurgery 20(6):930–937PubMedCrossRef Apuzzo ML, Chandrasoma PT, Cohen D, Zee CS, Zelman V (1987) Computed imaging stereotaxy: experience and perspective related to 500 procedures applied to brain masses. Neurosurgery 20(6):930–937PubMedCrossRef
24.
Zurück zum Zitat Kelly PJ (1986) Computer-assisted stereotaxis: new approaches for the management of intracranial intra-axial tumors. Neurology 36(4):535–541PubMed Kelly PJ (1986) Computer-assisted stereotaxis: new approaches for the management of intracranial intra-axial tumors. Neurology 36(4):535–541PubMed
25.
Zurück zum Zitat Kelly PJ, Ft E, Kall BA, Goerss SJ, Scheithauer B (1985) Surgical options for patients with deep-seated brain tumors: computer-assisted stereotactic biopsy. Mayo Clin Proc 60(4):223–229PubMed Kelly PJ, Ft E, Kall BA, Goerss SJ, Scheithauer B (1985) Surgical options for patients with deep-seated brain tumors: computer-assisted stereotactic biopsy. Mayo Clin Proc 60(4):223–229PubMed
26.
Zurück zum Zitat Sawin PD, Hitchon PW, Follett KA, Torner JC (1998) Computed imaging-assisted stereotactic brain biopsy: a risk analysis of 225 consecutive cases. Surg Neurol 49(6):640–649PubMedCrossRef Sawin PD, Hitchon PW, Follett KA, Torner JC (1998) Computed imaging-assisted stereotactic brain biopsy: a risk analysis of 225 consecutive cases. Surg Neurol 49(6):640–649PubMedCrossRef
27.
Zurück zum Zitat Thomas DG, Nouby RM (1989) Experience in 300 cases of CT-directed stereotactic surgery for lesion biopsy and aspiration of haematoma. Br J Neurosurg 3(3):321–325PubMedCrossRef Thomas DG, Nouby RM (1989) Experience in 300 cases of CT-directed stereotactic surgery for lesion biopsy and aspiration of haematoma. Br J Neurosurg 3(3):321–325PubMedCrossRef
28.
Zurück zum Zitat Cartmill M, Punt J (1999) Diffuse brain stem glioma. A review of stereotactic biopsies. Childs Nerv Syst 15(5):235–237, discussion 238PubMedCrossRef Cartmill M, Punt J (1999) Diffuse brain stem glioma. A review of stereotactic biopsies. Childs Nerv Syst 15(5):235–237, discussion 238PubMedCrossRef
29.
Zurück zum Zitat Chico-Ponce de Leon F, Perezpena-Diazconti M, Castro-Sierra E, Guerrero-Jazo FJ, Gordillo-Dominguez LF, Gutierrez-Guerra R, Salamanca T, Sosa-Sainz G, Santana-Montero BL, DeMontesinos-Sampedro A (2003) Stereotactically-guided biopsies of brainstem tumors. Childs Nerv Syst 19(5–6):305–310. doi:10.1007/s00381-003-0737-x PubMedCrossRef Chico-Ponce de Leon F, Perezpena-Diazconti M, Castro-Sierra E, Guerrero-Jazo FJ, Gordillo-Dominguez LF, Gutierrez-Guerra R, Salamanca T, Sosa-Sainz G, Santana-Montero BL, DeMontesinos-Sampedro A (2003) Stereotactically-guided biopsies of brainstem tumors. Childs Nerv Syst 19(5–6):305–310. doi:10.​1007/​s00381-003-0737-x PubMedCrossRef
32.
Zurück zum Zitat Roujeau T, Machado G, Garnett MR, Miquel C, Puget S, Geoerger B, Grill J, Boddaert N, Di Rocco F, Zerah M, Sainte-Rose C (2007) Stereotactic biopsy of diffuse pontine lesions in children. J Neurosurg 107(1 Suppl):1–4. doi:10.3171/PED-07/07/001 PubMed Roujeau T, Machado G, Garnett MR, Miquel C, Puget S, Geoerger B, Grill J, Boddaert N, Di Rocco F, Zerah M, Sainte-Rose C (2007) Stereotactic biopsy of diffuse pontine lesions in children. J Neurosurg 107(1 Suppl):1–4. doi:10.​3171/​PED-07/​07/​001 PubMed
33.
Zurück zum Zitat Valdes-Gorcia J, Espinoza-Diaz DM, Paredes-Diaz E (1998) Stereotactic biopsy of brain stem and posterior fossa lesions in children. Acta Neurochir (Wien) 140(9):899–903CrossRef Valdes-Gorcia J, Espinoza-Diaz DM, Paredes-Diaz E (1998) Stereotactic biopsy of brain stem and posterior fossa lesions in children. Acta Neurochir (Wien) 140(9):899–903CrossRef
34.
Zurück zum Zitat Choux MDRC, Hockley AD, Walker ML (1999) Pediatric neurosurgery. Brainstem tumors, 1st edn. Churchill Livingstone, London Choux MDRC, Hockley AD, Walker ML (1999) Pediatric neurosurgery. Brainstem tumors, 1st edn. Churchill Livingstone, London
Metadaten
Titel
Computed tomography-guided stereotactic biopsy of intracranial lesions in pediatric patients
verfasst von
Ali Meshkini
Sohrab Shahzadi
Alireza Zali
Khosro Parsa
Aimaz Afrough
Amir Hamdi
Publikationsdatum
01.12.2011
Verlag
Springer-Verlag
Erschienen in
Child's Nervous System / Ausgabe 12/2011
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-011-1534-6

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