Hagen T, Nieder C, Moringlane J R, Feiden W, König J
Institut für Neuroradiologie, Universitätskliniken des Saarlandes, Homburg/Saar.
Radiologe. 1995 Nov;35(11):808-15.
To determine the accuracy of preoperative neuroradiological diagnosis of pathological intracranial processes in a prospective study.
A team of three neuroradiologists determined the diagnosis in CT, MR and angiography prior to stereotactic biopsy or operative resection (173 patients). Only one diagnosis was allowed, except in those cases with two equally probable diagnosis (24 patients). In 106 patients a resection of a brain tumor, in 67 cases a stereotactic biopsy was performed. According to the histological diagnosis the patients were subdivided into three groups: 1: complete agreement: the single diagnosis was correct. 2: conditional agreement: on of the 2 differential diagnosis was correct. 3: no agreement
In 131 cases (76%) a complete agreement, in 24 cases (14%) a conditional agreement and in 18 patients (10%) no agreement were found. Assuming only stereotactic procedures the neuroradiological diagnosis was correct in 44 cases (66%) and incorrect in 10 cases (15%). In 13 patients (19%) one of the two differential diagnosis was correct. The specificity of the major tumors was calculated between 92% and 100%. The sensitivity for pituitary adenomas (n = 9) and neurinomas (n = 11) was 100%, the sensitivity for meningiomas (n = 32) was 94%. A sensitivity was calculated between 50% and 71% for astrocytomas (WHO I to WHO IV, n = 64) and metastases (n = 24).
The accuracy was found to be higher than in the comparable retrospective studies.
在前瞻性研究中确定术前神经放射学对颅内病理性病变诊断的准确性。
由三名神经放射科医生组成的团队在立体定向活检或手术切除前（173例患者），通过CT、MR和血管造影确定诊断。除了两种诊断可能性相同的情况（24例患者）外，只允许做出一种诊断。106例患者进行了脑肿瘤切除，67例进行了立体定向活检。根据组织学诊断，患者被分为三组：1：完全一致：单一诊断正确。2：有条件一致：两种鉴别诊断中的一种正确。3：不一致。
发现131例（76%）完全一致，24例（14%）有条件一致，18例（10%）不一致。仅考虑立体定向手术，神经放射学诊断在44例（66%）中正确，在10例（15%）中错误。13例（19%）患者的两种鉴别诊断中的一种正确。主要肿瘤的特异性计算在92%至100%之间。垂体腺瘤（n = 9）和神经鞘瘤（n = 11）的敏感性为100%，脑膜瘤（n = 32）的敏感性为94%。星形细胞瘤（世界卫生组织I级至世界卫生组织IV级，n = 64）和转移瘤（n = 24）的敏感性计算在50%至71%之间。
发现准确性高于类似的回顾性研究。
