Correlative tissue pathology of intracranial neurinomas with computed tomography scans

On computed tomography (CT) layers through the tumor the quality of picture depends upon the tumoral tissue structure, i.e., upon its histological appearance. In the formation of this histological appearance to a greater or lesser extent a series of various elements are involved, which are responsible for the density on CT scan, e.g., blood vessels, fatty tissue, calcium, connective tissue, collagen, etc. For some tumors the most important characteristic is specific organization of tissues in the volume, which can be clearly seen on high-quality CT scan. Possible limitations are due to technical capabilities of a CT apparatus. In our study we have obtained the most valuable results by analyzing the quality of picture of neurinomas on the so-called native CT scans, and by evaluating the way in which the picture of the tumoral tissue changed by opacification after an intravenous injection of contrast medium. Our study included 23 intracranial neurinomas. Twenty of them were neurinomas of the statoacoustic nerve, 1 of the orbit, 1 of the Gasser's gaglion and 1 was in the parasagittal region. For each particular tumor on histological specimens Antoni A and Antoni B types of tissue were semiquantitatively identified. In our study we have chosen only those cases for which we had a plenty of tumoral tissue suitable for semiserial analysis. The results of the histological analysis were compared with the results of the CT assessment of the tumoral tissue. Larger necrotic areas and cystic formations within tumoral tissue, which we could not analyze on our histological specimens, were excluded from the evaluation of CT scans of these tumors. Our results indicate a positive correlation between the histological appearance of neurinomas and their CT scans. This correlation between the histological properties of the tumoral tissue and the CT scan was almost 100% in those cases in which one histological type of neurinomas significantly prevailed. The prevalence of one type of neurinoma tissue was found in 74% of cases. In almost 61% of neurinomas in the histological appearance Antoni A type of tissue prevailed, what was clearly seen on CT in the form of hyperdense areas of the tumor. Antoni B type of tissue was histologically found in about 13% of neurinomas. These tumors had a marked hypodense picture of the tumoral tissue. The rest of neurinomas had mixed types of tissue. In this group of tumors we could not use the CT findings as an indicator in preoperative analysis of histopathological tissue characteristics.