Abstract:
Background: Brain tumors are common and fatal, therefore requiring medical
providers to have a basic understanding of their diagnosis and management. The
management of patients with brain tumors depends on the imaging finding. Magnetic
Resonance Imaging (MRI) is one of the imaging modalities while histopathology
diagnosis is the gold standard in the diagnosis of brain tumors. Histopathology
services are limited to referral hospitals, private laboratories and institutions.
Objective: To describe and compare the radiological findings and histopathological
diagnosis of primary brain tumors in adults at Moi Teaching and Referral Hospital
(MTRH).
Methods: This was a cross-sectional study design conducted from April 2019 to
March 2020 at the MTRH Eldoret-Kenya. A total of 79 patients were enrolled into the
study. Data was collected using interviewer administered questionnaire where the
MRI findings of the respondents were analyzed and recorded. Histopathological
diagnosis was followed up and recorded. Continuous variables, means and categorical
variables were summarized in frequency, percentages and bar graphs. The
comparison between the MRI and histopathology diagnosis of primary brain tumors
in adult patients at MTRH was done using sensitivity and specificity. This was
calculated using two-by-two (2X2) tables.
Results: The age of the participants ranged from 18 to 85 years with a mean age of 46
years. The commonest clinical presentations were headache 71(80.68%), seizures
26(29.55%), vomiting 24(27.2%) and blurred vision 16(18.18%). The MRI diagnosis
of brain tumors was meningioma 29(36.36%), glioblastoma, 24(30.68%) pituitary
adenomas 12(13.64%) and diffuse astrocytoma 7(9.09%). There was a significant
statistical association between tumor margins and type of tumor (p-value=0.044,
Fisher Exact test). The presence of perilesional edema was significantly associated
with the histopathological diagnosis (p-value=0.049, Fisher Exact test). The
sensitivity of MRI in the diagnosis of meningioma, glioblastoma, pituitary adenoma
and diffuse astrocytoma were 96.7%, 88.5%, 90.9% and 66.7 % respectively. The
specificity ranged from 92.5-98.6 %. The overall diagnostic agreement between MRI
and histopathology in the diagnosis of adult primary brain tumors in this study was
86.1%.
Conclusion: The most common brain tumors in our study were meningiomas,
glioblastoma, pituitary adenoma and diffuse astrocytoma in both radiological and
histopathological diagnosis. The sensitivity and specificity of MRI in diagnosis of
brain tumors ranged from 66.7%-96.8% and 92.5%-98.6% respectively.
Recommendation: Use of MRI in the diagnosis of primary brain tumors in adults
and guiding management is recommended.