Serhat YILDIZHAN, Adem ASLAN, Mehmet Gazi BOYACI, Çiğdem ÖZER GÖKASLAN, Usame RAKİP, Kamil Anıl KILINÇ

KRANİYAL LEZYONLARIN AYIRICI TANISINDA MAGNETİK REZONANS SPEKTROSKOPİNİN ÖNEMİ VE PATOLOJİ SONUÇLARI İLE KORELASYONU

AMAÇ: Kraniyal lezyonlarda tedavi algoritmasının belirlenmesinde operasyon öncesi tanı çok önemlidir. Bu çalışma ile preoperatif yapılan görüntüleme yöntemlerinden magnetik rezonans spektroskopi sonuçlarının patoloji sonuçları ile karşılaştırılması ile tanı koymadaki etkinliğinin ortaya konulması amaçlanmıştır.GEREÇ VE YÖNTEM: 2016 - 2019 yılları arasında kliniğimizde kranial yer kaplayıcı lezyon nedeniyle opere edilen 75 hasta içerisinden operasyon öncesi magnetik rezonans spektroskopi görüntülemesi yapılan 35 hasta çalışmaya alındı. Biyokimyasal metabolit olarak N-asetil aspartat, kreatin, kolin ve laktat değerleri hesaplandı ve bu değerlere göre konulan preoperatif tanılar postoperatif patoloji sonuçları ile karşılaştırılarak literatür eşliğinde tartışıldı.BULGULAR: Çalışmaya 20 erkek, 15 kadın toplam 35 hasta dahil edildi. Hastaların yaş aralığı 18 - 82 arasında idi. Magnetik rezonans spektroskopi sonucunda 29 hastada yüksek gradeli glial tümör tanısı kondu. Operasyon sonrası değerlendirme sonucunda 27 hastanın magnetik rezonans spektroskopi sonucu ile patoloji sonuçları uyumlu bulunurken 8 hastada farklılıklar görüldü. Yüksek gradeli glial tümörlerde kolin piki ve kolin/NAA oranında belirgin artma dikkat çekti.SONUÇ: Kraniyal lezyonların ayırıcı tanısında yapılan magnetik rezonans spektroskopi ile elde edilen preoperatif değerlendirmeler ile patolojik tanı arasında yüksek oranda korelasyon mevcutdur.

Anahtar Kelimeler:

Tümör, Spektroskopi, Cerrahi, Patoloji

THE IMPORTANCE OF MAGNETIC RESONANCE SPECTROSCOPY IN THE DIFFERENTIAL DIAGNOSIS OF CRANIAL LESIONS AND ITS CORRELATION WITH PATHOLOGY RESULTS

OBJECTIVE: Preoperative diagnosis is very important in determining the treatment algorithm in cranial lesions. The aim of this study is to compare the results of magnetic resonance spectroscopy, which is one of the preoperative imaging methods, with the results of pathology and to reveal its effectiveness in diagnosis.MATERIAL AND METHODS: Thirty five patients who underwent preoperative magnetic resonance spectroscopy imaging among 75 patients who were operated for cranial lesions in our clinic between 2016 - 2019 were included in the study. N-acetyl aspartate, creatine, choline and lactate values were calculated as biochemical metabolites, and preoperative diagnoses made according to these values were compared with postoperative pathology results and discussed in the light of the literature.RESULTS: A total of 35 patients, 20 male and 15 female, were included in the study. The age range of the patients was between 18 - 82. As a result of magnetic resonance spectroscopy, 29 patients were diagnosed with high grade glial tumors. As a result of the postoperative evaluation, the magnetic resonance spectroscopy results of 27 patients were found to be compatible with the pathology results, while differences were observed in 8 patients. A significant increase in choline peak and choline / NAA ratio was noted in high-grade glial tumors.CONCLUSIONS: There is a high correlation between the preoperative evaluations obtained by magnetic resonance spectroscopy which is used in the differential diagnosis of cranial lesions, and the pathological diagnosis.

Keywords:

Tumor, Spectroscopy, Surgery, Pathology,

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