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Space occupying lesions of brain on MRI: Clinical study at a tertiary care hospital

Kadam Mahesh M^1*, Patil Swapnil²

¹Assistant Professor, ²Senior Resident, Department of Radio diagnosis, Government Medical College, Latur, Maharashtra, INDIA.

Email: mahesh2kadam@gmail.com

Research Article

 

Abstract               Background: The availability of magnetic resonance imaging (MRI) has caused a revolution in the approach towards the management of intracranial lesions. Midline masses, multiple or very small lesions which were not diagnosed by angiography or other methods can now precisely be seen with M.R.I. Objective: Present study was done to describe the clinical profile of patients with Space Occupying Lesions of brain visualized on MRI at a tertiary care hospital. Methods: A cross sectional observational study of 50 patients who were found to have focal intra cranial pathologies on routine MRI was done at our tertiary care hospital. Institutional ethics committee clearance was obtained prior to the study. Duration of our study was from 1^st December 2012 to 31^st October 2014. The study was carried out on GE SIGNA HDX 1.5 Tesla MRI machine. Patients referred by clinical departments whose MRI study revealed space occupying lesions in brain were included in the study. A brief clinical history, correlating with their examination findings was noted down from the patient. Results and Conclusions: From the total of 50 patients included in the study, 25 (50 %) patients were found to have convulsions as their chief complaint, 20 (40 %) had headache, 2 (4 %) were unconscious, 2 (4 %) patient had fever and 1 (2 %) patient was asymptomatic (This patient had multiple cysticerci in muscles but no neurological complaint). Most of the patients had more than one symptom as presenting complaints. Maximum numbers of patients were in the age group of 51-60 yrs (36 %). 31 (62%) patients were males and 19 (38 %) were females. No significant difference in the laterality of the disease is seen with 15 patients having midline/ bilateral involvement. Thus, present study describes the clinical profile of patients with Space Occupying Lesions of brain visualized on MRI at a tertiary care hospital.

Keywords: Space occupying lesions of brain, Magnetic resonance imaging, Convulsions.

 

INTRODUCTION

The term space occupying lesions of brain is conveniently applied to localized intracranial lesions whether of neoplastic, vascular or chronic/ acute inflammatory origin, which by virtue of occupying space within the skull tends to cause raised intracranial tension¹. Intracranial space occupying lesions comprise of a diverse group of lesions. The high morbidity and mortality associated with them necessitates their early diagnosis so as to plan the intervention that is required ^[2]. Magnetic resonance imaging (MRI) has been considered to be the gold standard for preoperative diagnosis, local staging and the post therapeutic monitoring for brain tumours^3,4,5. The availability of magnetic resonance imaging (MRI) has caused a revolution in the approach towards the management of intracranial lesions. Midline masses, multiple or very small lesions which were not diagnosed by angiography or other methods can now precisely be seen with M.R.I⁶. Present study was done to describe the clinical profile of patients with Space Occupying Lesions of brain visualized on MRI at a tertiary care hospital.

 

METHODS

A cross sectional observational study of 50 patients who were found to have focal intra cranial pathologies on routine Magnetic resonance imaging (MRI) was done at our tertiary care hospital. Institutional ethics committee clearance was obtained prior to the commencement of the study. Duration of our study was from the 1^st December 2012 to the 31^st October 2014. The study was carried out on the GE SIGNA HDX 1.5 Tesla Magnetic resonance imaging (MRI) machine. Patients referred by clinical departments whose MRI study revealed space occupying lesions in brain were included in the study. Patients who were already diagnosed and were under treatment and the post-operative cases were excluded from the study. Subjects with contraindications for MRI were also excluded. Written and informed consent was taken from all the participants. A brief clinical history, correlating with their examination findings was noted down from the patient.

 

RESULTS

 

Following observations were made during the study.

 

Table 1: Clinical Presentation

 

In the present study, maximum numbers of patients were found to be in the age group of 51-60 years (36 %).

 

Table 2: Age group of the patients

 

In our study of 50 patients, 31 (62%) patients were males and 19(38 %) were females.

 

Table 3: Gender distribution

 

Table 4: Disease Laterality

No significant difference in the laterality of the disease is seen with 15 patients having midline/ bilateral involvement.

 

DISCUSSION

Present study describes the clinical profile of patients with Space Occupying Lesions of brain visualized on MRI at a tertiary care hospital. In terms of incidence, convulsions (50 %) were the most common presenting complaint in our study followed by head ache (40 %). However in study by Goyani et al⁷ headache was the most frequent symptom (51.42%) followed by Seizures (32.85%). In this study, age of patient ranged from 5-71 years with maximum number of patients in the age group of 51-60 years (36 %) followed by 21-30 years (18 %). The mean age of the patient in the study conducted by Burstcher IM et al⁸ was 52 years which is similar to this study. However, in the study by Goyani et al⁷, majority of the patients were in the fourth decade (28.5%). In our study of 50 patients, 31 (62 %) patients were males and 19 (38 %) were females. Similar male preponderance was observed in the study conducted by Butzen J et al⁹ and Kumar et al¹⁰. Thus, present study gives valuable information regarding the clinical profile of patients with space occupying lesions of brain visualized on MRI at our tertiary care hospital.

 

REFERENCES

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9. Butzen J, Prost R, Chetty V, Donahue K, Neppl R, Bowen W, et al. Discrimination between Neoplastic and Nonneoplastic Brain Lesions by Use of Proton MR Spectroscopy The Limits of Accuracy with a Logistic Regression Model. AJNR Am J Neuroradiol. 2000; 21(August):1213–9.
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