Radha Rani Kaki1, Bonthu Anuradha2, Bomidi Sudha Rani3, Karri Sambasiva Rao4, Pasam Kusumalatha5, Kommana Satyasuneetha6
The high morbidity and mortality associated with ICSOLs necessitates their early diagnosis so as to plan the required intervention. An analysis of 50 cases of Intracranial Space Occupying Lesions (ICSOL) including neoplastic and non-neoplastic masses diagnosed and treated at GGH, Kakinada, over a period of one year is presented. CT scan and MRI were used for the diagnosis.
MATERIALS AND METHODS
In this prospective cohort study, 50 patients with ICSOL were studied predominantly by MRI and also by CT and MRS (wherever necessary). Imaging findings were evaluated, tabulated and correlated with histopathological findings and also clinical findings (wherever available). The findings were statistically analysed.
Most patients were in age range of 50-60 years. Male:female ratio was 2:3. Most common presenting symptom was headache associated with vomiting. Predominantly, solitary lesions were present in 47 patients (94%) and multiple lesions in three patients (6%). 39 cases were supratentorial, 10 cases were infratentorial and one lesion was both supra and infratentorial in location. 40 patients were having neoplastic lesions (80%) and 10 had non-neoplastic lesions (20%). In our study, meningiomas were the most common neoplastic lesion while among non-neoplastic lesions, arachnoid cysts were the most common. Of the neoplastic cases, 12 cases (30%) were malignant and 28 (70%) cases were benign mass effect was the most common associated imaging finding. For neoplastic lesions, the imaging sensitivity was 92.5%, specificity was 70%, accuracy was 88%, positive predictive value was 92.5% and negative predictive value was 70%. While for the non-neoplastic lesions, imaging sensitivity was 70%, specificity was 92.5% and accuracy was 88%.
Neuroimaging in combination with clinical findings can be helpful in early diagnosis and localisation of ICSOL and for proper management of the patient. The neurosurgeon, neuroradiologist and neuropathologist form a triad that is essential for diagnosis, management and follow up of these cases.