ABSTRACT
Objective: To determine the accuracy of MR Spectroscopy [MRS] in diagnosing brain tumors
Study Design: Analytical study
Place and Duration of Study: Neurosurgery Department, Jinnah Postgraduate Medical Centre, Karachi, from November 2010 to April 2011
Methodology: Fifty cases with brain tumors, who presented to Neurosurgery Department of Jinnah Postgraduate Medical Centre, Karachi, during the study period, were included in the study. All patients underwent MRS and later brain. Those with recurrent disease were excluded. Data was collected with the help of proforma. Data was analyzed using SPSS version 16. Comparison of MRS findings and biopsy diagnosis was done. Sensitivity, specificity, negative and positive predictive values [NPV and PPV] were determined keeping histopathology as the gold standard
Results: Out of the 50 patients, there were 20 [40%] females and 30 [60%] males with mean age of 37 +/- 13.24 years. The commonest presenting complaint was headache [76%] followed by weakness [62%] and seizures [30%]. MRI had diagnosed 27 [51%] as neoplastic lesion. Spectroscopy reported 44 [88%] as neoplasms, while on histopathology, 42 [84%] were confirmed to have neoplasm. The accuracy of MRS was 94%, with 97.6% sensitivity, 71.42% specificity, 95.45% PPV and 83.3% NPV
Conclusion: Magnetic resonance spectroscopy can readily help in differentiating neoplasm from non-neoplastic brain tumors, thus an invasive brain biopsy procedure can be avoided
ABSTRACT
To evaluate the neurological outcome of anterior decompression and fixation with Webb-Morley procedure in dorsolumbar spinal injuries. A case series study. The Neurosurgery Department, Jinnah Postgraduate Medical Centre, Karachi, from May 2008 to July 2010. Patients with post-traumatic unstable dorsolumbar spine having compression of the spinal cord with bony fragments of the fractured vertebra were included in the study. Patients below the age of 15 years and patients with bed sores and unfit for anaesthesia were excluded. Plain X-rays and magnetic resonance imaging [MRI] were done. All patients were treated for dorsolumbar fractures by anterior decompression and fixation with Webb-Morley procedure. All patients were assessed clinically by the Frankel's grading before and after surgery. Among 60 patients, 41 were males and 19 were females. Mean age was 37.2 +/- 4 years. Major cause of trauma was road traffic accident. The commonest level of the fracture was at the dorsolumbar junction i.e. 71.66% [n = 43]. About 19 [31.66%] patients improved to the Frankel's grade-E, while 41.66% [n = 25] improved to grade-D after surgery. There was no postoperative mortality. According to the current study, anterior decompression and fixation with Webb-Morley procedure is an effective and safe approach. Those patients who had complete motor deficit showed no improvement in power but those who had partial motor deficit, had excellent improvement