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Brain Tumor Diagnosis

Magnetic Resonance Imaging (MRI)
A magnetic resonance imaging (MRI) scan is a test that uses a powerful magnet linked to a computer to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed. In some cases, a special dye will be injected into the body to help show differences in the tissues of the brain. The pictures can show a tumor or other problems in the brain.
During an angiogram, a dye is injected into the bloodstream that flows into the blood vessels in the brain to make them show up on an x-ray. If a tumor is present, the doctor may be able to see the tumor on the x-ray.
Skull X-Ray
Some types of brain tumors cause calcium deposits in the brain or changes in the bones of the skull. An x-ray of the skull can be used to check for these changes.
Spinal Tap
The doctor may remove a sample of cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord). This procedure is performed under local anesthesia. The doctor will use a long, thin needle to remove fluid from the spinal column. A spinal tap takes about 30 minutes, and the patient must lie flat for several hours afterward to keep from getting a headache. A laboratory will check the fluid for cancer cells or other signs of problems.
A myelogram is an x-ray of the spine. A spinal tap is performed to inject a special dye into the cerebrospinal fluid, and the patient is tilted to allow the dye to mix with the fluid. This test helps the doctor to detect a tumor in the spinal cord.
The removal of tissue to look for brain tumor cells is called a biopsy. A pathologist will look at the cells under a microscope to check for abnormal cells. A biopsy can show cancer, tissue changes that may lead to cancer, and other conditions. A biopsy is the only sure way to make a brain tumor diagnosis.
Surgeons can obtain tissue to look for tumor cells in three ways, which include:
  • Needle biopsy -- This is a procedure in which the surgeon makes a small incision in the scalp and drills a small hole into the skull. This is called a burr hole. The doctor will then pass a needle through the burr hole and remove a sample of tissue from the brain tumor.
  • Stereotactic biopsy -- This is a procedure that uses an imaging device, such as CT or MRI, to guide the needle through the burr hole to the location of the tumor. The surgeon will then withdraw a sample of tissue with the needle.
  • Biopsy  -- Sometimes, the surgeon will take a tissue sample at the same time surgery is being performed to remove the tumor.
In some cases, a biopsy is not possible. If the tumor is in the brain stem or other areas, the surgeon may not be able to remove tissue from the tumor without damaging normal brain tissue. Instead, the doctor will use MRI, CT, or other imaging tests.
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