Positrocefalografia: resultados em 1.400 casos. Estudo comparativo com a angiografia, a pneumencefalografia e a eletrencefalografia

Wilcke, O.; Brock, M.

doi:10.1590/S0004-282X1965000400003

Resumos

Dentre 1.400 doentes examinados, o positrocefalograma (PCG) permitiu a localização correta em 77% dos casos com tumor cerebral. A segurança para a exclusão do diagnóstico de tumor situou-se entre 76% e 87%. Pela associação dos dados obtidos angiogràficamente com os proporcionados pelo PCG foi possível estabelecer o diagnóstico topográfico preciso em 97% dos casos de tumor. Além disso foi conseguida substancial melhoria das previsões quanto à espécie do tumor. Associado ao EEG, o PCG proporciona aprimoramento tão nítido do diagnóstico em casos de ambulatório que, de regra, quando são negativos para tumor os resultados do exame neurológico, do EEG, do PCG e da radiologia simples, é lícito desistir da execução de métodos contrastados de diagnóstico. Isto elimina, em especial, a sobrecarga constituída pelos doentes com crises convulsivas, nos quais o esclarecimento do diagnóstico e a exclusão da existência de tumor cerebral só eram possíveis mediante internação dos pacientes.

Among a total of 1,400 examined cases, the positrocephalogram (PCG) allowed correct localization in 77% of the patients with a brain tumor. The diagnostic safety for the exclusion of an expansive process varied from 76% to 87%. By associating the data obtained through angiography with those furnished by the PCG it has been possible to establish a precise site diagnosis in 97% of the cases of brain tumor. Additional substantial improvement was attained as far as the diagnosis of the tumor type is concerned. When associated with the EEG, the PCG represents such a marked improvement in policlinical diagnosis that, as a rule, if the results of the neurological examination, the EEG, the PCG and plain radiology are negative for tumor, it is valid to give up further contrast methods. This mainly eliminates the overchange represented by patients with convulsive disorders as, up to now, diagnostic research in order to exclude a brain tumor in such cases was only possible with safety by means of stationary observation.

Bei insgesamt 1400 untersuchten Fällen konnte mit dem Positrocephalo-gramm (PCG) in 77% der Tumorfälle eine richtige Tumorlokalisation erzielt werden. Die diagnostische Sicherheit beim Tumorausschluss lag zwischen 76% und 87%. Durch die Kombination der im Angiogramm und PCG gewon-nenen Befunde konnten 97% der Grosshirntumoren genau lokalisiert werden und darüber hinaus ist damit eine wesentliche Verbesserung der artdiagno-stischen Voraussagen möglich. In Verbindung mit dem EEG bietet das PCG sowohl zum Tumorausschluss, als auch zum Tumornachweis eine so wesentliche Verbesserung der bisherigen poliklinischen Diagnostik, dass in der Regel bei negativem neurologischen-, EEG-, Isotopen- und Röntgen-befund auf die Kontrastmitteldiagnostik verzichtet werden kann, wodurch besonders bei der Abklärung von Anfallsleiden die nur stationär durchzu-führenden klinische Diagnostik entlastet wird.

Departamento de Neurocirurgia do Hospital da Polícia Militar do Estado da Guanabara (Brasil); bolsista do Serviço Alemão de Intercâmbio Acadêmico (D.A.A.D.)

RESUMO

Dentre 1.400 doentes examinados, o positrocefalograma (PCG) permitiu a localização correta em 77% dos casos com tumor cerebral. A segurança para a exclusão do diagnóstico de tumor situou-se entre 76% e 87%. Pela associação dos dados obtidos angiogràficamente com os proporcionados pelo PCG foi possível estabelecer o diagnóstico topográfico preciso em 97% dos casos de tumor. Além disso foi conseguida substancial melhoria das previsões quanto à espécie do tumor. Associado ao EEG, o PCG proporciona aprimoramento tão nítido do diagnóstico em casos de ambulatório que, de regra, quando são negativos para tumor os resultados do exame neurológico, do EEG, do PCG e da radiologia simples, é lícito desistir da execução de métodos contrastados de diagnóstico. Isto elimina, em especial, a sobrecarga constituída pelos doentes com crises convulsivas, nos quais o esclarecimento do diagnóstico e a exclusão da existência de tumor cerebral só eram possíveis mediante internação dos pacientes.

ABSTRACT

Among a total of 1,400 examined cases, the positrocephalogram (PCG) allowed correct localization in 77% of the patients with a brain tumor. The diagnostic safety for the exclusion of an expansive process varied from 76% to 87%. By associating the data obtained through angiography with those furnished by the PCG it has been possible to establish a precise site diagnosis in 97% of the cases of brain tumor. Additional substantial improvement was attained as far as the diagnosis of the tumor type is concerned. When associated with the EEG, the PCG represents such a marked improvement in policlinical diagnosis that, as a rule, if the results of the neurological examination, the EEG, the PCG and plain radiology are negative for tumor, it is valid to give up further contrast methods. This mainly eliminates the overchange represented by patients with convulsive disorders as, up to now, diagnostic research in order to exclude a brain tumor in such cases was only possible with safety by means of stationary observation.

ZUSAMMENFASSUNG

Bei insgesamt 1400 untersuchten Fällen konnte mit dem Positrocephalo-gramm (PCG) in 77% der Tumorfälle eine richtige Tumorlokalisation erzielt werden. Die diagnostische Sicherheit beim Tumorausschluss lag zwischen 76% und 87%. Durch die Kombination der im Angiogramm und PCG gewon-nenen Befunde konnten 97% der Grosshirntumoren genau lokalisiert werden und darüber hinaus ist damit eine wesentliche Verbesserung der artdiagno-stischen Voraussagen möglich. In Verbindung mit dem EEG bietet das PCG sowohl zum Tumorausschluss, als auch zum Tumornachweis eine so wesentliche Verbesserung der bisherigen poliklinischen Diagnostik, dass in der Regel bei negativem neurologischen-, EEG-, Isotopen- und Röntgen-befund auf die Kontrastmitteldiagnostik verzichtet werden kann, wodurch besonders bei der Abklärung von Anfallsleiden die nur stationär durchzu-führenden klinische Diagnostik entlastet wird.

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Trabalho da Clinica Neurocirúrgica da Universidade de Colônia e do Instituto Max Planck de Pesquisas Cerebrais, Departamento de Pesquisas Tumorais e Patologia Experimental, Colônia, Alemanha (Diretor: Prof. Dr. W. Tönnis)

1. ANGER, H. O. - Gamma-ray and positron scintillation camera. Nucleonics 21:56-59, 1963.
2. BLAU, M. & BENDER, M. A. - Clinical evaluation of Hg^:KI-neohydrin and I¹⁸¹-albumin in brain tumor localization. J. Nucl. Med., 1:106-107, 1960.
3. BROWNELL, G. L. & SWEET, W. H. - Localization of brain tumors with positron emitters. Nucleonics 11:40-45, 1953.
4. DI CHIRO, G. - RISA-Encephalo-graphie und konventionelle neuroradiologische Methoden. Eine vergleichende Studie. Acta radiol. (Stockholm), Suppl. 201, 1961.
5. FEINDEL, W.; YAMAMOTO, L.; McRAE, D. L. & ZANELLI, J. - Contour brain scanning with iodine and mercury compounds for detection of intracranial tumors. Amer. J. Roentgenol., 92:177-186, 1964.
6. McAFEE, J. G. & TAXDAL, D. R. - Comparison of radioisotope scanning with cerebral angiography and air studies in brain tumor localization. Radiology 77: 207-222, 1961.
7. MUNDINGER, F. - The localization of brain tumors by means of radioisotope. Positron radiators for brain tumor localization. Medicamundi 7: 127-130, 1961.
8. PLANIOL, T. - La gamma-encéphalographie. Rev. du Praticien 30:3625-3642, 1963.
9. TAUXE, W. N.; SEDLACK, R. E.; PITLYK, P. J. & KERR, F. W. L. - Preliminary report on the localization of brain lesions with I^I3I-labelled polyvinylpyrrolidone. Proc. Mayo Clin., 37:109-111, 1962.
10. WILCKE, O. - Die differentialdiagnostischen Mõglichkeiten der Positron-Enzephalographie (Cu⁶⁴ und As"). Féd. Mond. Neurol., Strassbourg, 23-24, IX, 1963.
11. WILCKE, O. - Mõglichkeiten und Grenzen der Hirntumordiagnostik mit Positronenstrahlern (C⁶⁴ und As⁷⁴). Neurochirurgia 7:33-41, 1964.
12. WILCKE, O. - Results of positron-scanning in 1200 cases for diagnosis of intracranial lesions. Intern. Atomic Energy Sympos. on Med. Radioisotope Scanning, Atenas, 20 a 24, IV, 1964.

Positrocefalografia. resultados em 1.400 casos. Estudo comparativo com a angiografia, a pneumencefalografia e a eletrencefalografia

O. Wilcke; M. Brock

Datas de Publicação

Publicação nesta coleção
15 Ago 2013
Data do Fascículo
Dez 1965

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ANGER, H. O. - Gamma-ray and positron scintillation camera. Nucleonics 21:56-59, 1963.

[2] 2. BLAU, M. & BENDER, M. A. - Clinical evaluation of Hg^:KI-neohydrin and I¹⁸¹-albumin in brain tumor localization. J. Nucl. Med., 1:106-107, 1960.

[3] 3. BROWNELL, G. L. & SWEET, W. H. - Localization of brain tumors with positron emitters. Nucleonics 11:40-45, 1953.

[4] 4. DI CHIRO, G. - RISA-Encephalo-graphie und konventionelle neuroradiologische Methoden. Eine vergleichende Studie. Acta radiol. (Stockholm), Suppl. 201, 1961.

[5] 5. FEINDEL, W.; YAMAMOTO, L.; McRAE, D. L. & ZANELLI, J. - Contour brain scanning with iodine and mercury compounds for detection of intracranial tumors. Amer. J. Roentgenol., 92:177-186, 1964.

[6] 6. McAFEE, J. G. & TAXDAL, D. R. - Comparison of radioisotope scanning with cerebral angiography and air studies in brain tumor localization. Radiology 77: 207-222, 1961.

[7] 7. MUNDINGER, F. - The localization of brain tumors by means of radioisotope. Positron radiators for brain tumor localization. Medicamundi 7: 127-130, 1961.

[8] 8. PLANIOL, T. - La gamma-encéphalographie. Rev. du Praticien 30:3625-3642, 1963.

[9] 9. TAUXE, W. N.; SEDLACK, R. E.; PITLYK, P. J. & KERR, F. W. L. - Preliminary report on the localization of brain lesions with I^I3I-labelled polyvinylpyrrolidone. Proc. Mayo Clin., 37:109-111, 1962.

[10] 10. WILCKE, O. - Die differentialdiagnostischen Mõglichkeiten der Positron-Enzephalographie (Cu⁶⁴ und As"). Féd. Mond. Neurol., Strassbourg, 23-24, IX, 1963.

[11] 11. WILCKE, O. - Mõglichkeiten und Grenzen der Hirntumordiagnostik mit Positronenstrahlern (C⁶⁴ und As⁷⁴). Neurochirurgia 7:33-41, 1964.

[12] 12. WILCKE, O. - Results of positron-scanning in 1200 cases for diagnosis of intracranial lesions. Intern. Atomic Energy Sympos. on Med. Radioisotope Scanning, Atenas, 20 a 24, IV, 1964.