Astrocytomas are tumors that arise from astrocytes—star-shaped cells that make up the “glue-like” or supportive tissue of the brain. Astrocytomas can appear in various parts of the brain and nervous system, including the cerebellum, the cerebrum, the central areas of the brain, the brainstem and the spinal cord. The main objective of this study was to detect the sensitivity of the CT scan in diagnosis of the brain astrocytoma, in patients who were confirmed as brain gliomas using computerized tomography of the brain versus brain tissue biopsy after surgery. One hundred and one patients were included in this study. Bio-data collected for these patients (age, gender), radiographic appearance, contrast enhancement and the site of the tumor, were statistically analyzed. Out of the 101 patients with brain gliomas, 52 (51.5%) were male whose ages ranged between 1 and 80 years, and 64 (63.4%) cases were diagnosed as astrocytoma by CT. This study concluded that the CT brain was sensitive in the diagnosis of brain astrocytomas.
Astrocytomas are glial cell tumors that are derived from connective tissue cells called astrocytes. These cells can be found anywhere in the brain or spinal cord. Astrocytomas are the most common type of childhood brain tumor and the most common type of primary brain tumor in adults. Astrocytomas are generally subdivided into high-grade or low-grade tumors. High-grade astrocytomas are the most malignant of all brain tumors. Furthermore, astrocytomas are classified for presenting signs, symptoms, treatment and prognosis based on the location of the tumor. Patients usually have symptoms of increased intracranial pressure, headache, and vomiting also seizures, memory loss, and changes in behavior are the most common early symptoms of astrocytoma. Other symptoms may occur depending on the size and location of the tumor. There can also be problems with walking and coordination, as well as double vision. In adults, astrocytomas are more common in the cerebral hemispheres (cerebrum), where they commonly cause increased intracranial pressure (ICP), seizures, or changes in behavior [
Some physicians may also request an MRS (magnetic resonance spectroscopy) scan which measures chemical and mineral levels in a tumor. Those measurements may give a suggestion as to whether a tumor is malignant or benign. It may also help distinguish a brain tumor from other medical problems, such as infection (tuberculosis, parasite, bacterial and fungus), demyelination (a disease that damages the myelin or protective sheath of a brain’s neurons) or a stroke. On MRI with contrast, high grade gliomas show brightly (this is called enhancement).
The importance of this study is to test CT sensitivity in investigation of astrocytomas.
The main objective of this study is to detect the sensitivity of the CT scan in diagnosis of the brain gliomas.
A CT scan uses a sophisticated X-ray machine linked to a computer to produce detailed, two-dimensional images of the brain. A patient lies still on a movable table that is guided into what looks like an enormous doughnut where the images are taken. A special dye may be injected into the bloodstream after a few CT scans to help better distinguish tumors (CT angiogram). A CT scan is painless and generally takes less than 10 minutes [
There were 100 patients with different types of brain masses had been diagnosed as gliomas attended in neurosurgery department of Elshaab Teaching Hospital in Khartoum state. The sample had been selected randomly by the technique of non probability method. The study had been conducted from the period of 2009 up to 2012. The data had been analyzed by statistically package for social sciences SPSS.
The patient lies supine on the scanning couch and is advanced towards the scanning field in the gantry. A scout image is generated by energizing the X-ray beam and passing the relevant part of the patient in one movement through the gantry. This continuous exposure as the patient moves through the beam generates a topogram which resembles a plain X-ray. In the case of the head, this is usually a lateral image of the skull. It is by nature a digital image and the windowing options already described can also be applied to it. From this scout image, the position number, and angulations of the subsequent slices are chosen. The axial plane is used most often for brain imaging. The axial plane offers the advantage of direct left to right comparison, which is useful in symmetrical structures like the head [
A biopsy is usually required to diagnose a brain tumor and confirm its type. In a biopsy, a tiny piece of tumor is removed for examination under a microscope. A biopsy can be performed separately or as part the surgery to remove the tumor [
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In the diagnosis of 100 cases of brain glioma the CT scan diagnoses (64 patients) (63.4%), and after the biopsy result confirmation the number of the patients decreased to (39 patients) (38.6%) as in image in
As in study (6) performed by Kendall et al. out of (13 patients) suffered from low grade astrocytomas (6 patients) (0.46%). And the remaining 7 patients were the different type of gliomas [
In study which done by Bbadhe et al., they studied the brainstem gliomas―A clinicopathological for 45 cases with p53 immunohistochemistry, they concluded that diffuse astrocytomas were seen in 40 cases (5% were Grade I, 47.5% Grade II, 32.5% Grade III and 15% Grade IV) [
Gender | Frequency | Percentage |
---|---|---|
Male | 52 | 53.1% |
Female | 48 | 46.9% |
Total | 100 | 100% |
Age Group (Years) | Frequency | Percent |
---|---|---|
Less than 10 | 15 | 14.9 |
10 - 24 | 15 | 14.9 |
25 - 39 | 30 | 29.7 |
40 - 54 | 24 | 23.8 |
55 - 70 | 14 | 13.9 |
Above 70 | 3 | 3.0 |
Total | 101 | 100 |
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The study showed that the sensitivity of CT in the diagnosis of astrocytoma was 79%. Male was common affected than female. The middle age was common affected age.
The sensitivity = True positive/True positive + False negative
Contrast Enhancement | ||||
---|---|---|---|---|
Enhanced | Not Enhanced | Total | ||
Radiodensity | Hyperdensic | 33 | 0 | 33 |
Hypodensic | 17 | 3 | 20 | |
Mixed | 10 | 1 | 11 | |
Total | 60 | 4 | 64 |
Actual | ||
---|---|---|
Test | Positive | Negative |
Positive | TP | FP |
Negative | FN | TN |
TP = true positive.
Further studies were required to study the brain glioma and its etiology.
Authors would like to thank all staff of Al Shaab Teaching Hospital for their efforts during data collection phase.