What are the ancillary tests for glioma?

  Transglioma, also known as glioblastoma, or glioma for short, is a tumor that occurs in the neuroectoderm, so it is also called neuroectodermal tumor or neuroepithelial tumor. Tumors originate from neurointerstitial cells, i.e., glial, ventricular canal, choroid plexus epithelium and neuroparenchymal cells, i.e., neurons. Most tumors originate from different types of glia, but based on the similar histogenetic origin and biological characteristics, all kinds of tumors that occur in the neuroectoderm are generally referred to as gliomas.  The diagnosis is based on their age, sex, site of occurrence and clinical course, and the pathological type is estimated. In addition to the medical history and neurological examination, some auxiliary examinations are also needed to help the diagnosis and characterization.  Some tumors located on the surface of the brain or in the ventricles of the brain may increase the amount of cerebrospinal fluid protein and the number of white blood cells, and some tumor cells may be detected. However, if the intracranial pressure is significantly increased, lumbar puncture may promote the risk of brain herniation. Therefore, it is usually done only when necessary and when it is necessary to differentiate from inflammation or hemorrhage. In cases of significant pressure increase, the operation should be performed with caution and not to release more cerebrospinal fluid. Give mannitol drip after the operation and pay attention to observation.  2.Ultrasonic examination can help to fix the side and observe whether there is hydrocephalus. For infants, B-type ultrasound scan can be performed through fontanel, which can show tumor images and other pathological changes.  3.Electroencephalography The EEG changes of glioma are, on the one hand, the changes of brain waves confined to the tumor site. On the other hand, they are general widely distributed changes of frequency and wave amplitude. These are influenced by tumor size, infiltration, degree of cerebral edema and increased intracranial pressure, etc. Superficially located tumors are prone to limited abnormalities, while deeper tumors are less likely to have limited changes. In the more benign astrocytomas and oligodendrogliomas, they mainly present as limited delta waves, with some seeing epileptic waveforms such as spikes or sharp waves. Large glioblastoma multiforme may show widespread δ waves, sometimes only fixed laterally.  4.Radioisotope scan (Y-ray brain map) Tumors with fast growth and rich blood flow have high blood-brain barrier permeability and high isotope uptake rate. For example, glioblastoma multiforme shows isotope concentrated image, and there may be low density area formed by necrosis and cyst in the middle, which should be differentiated from metastases according to its shape and multiplicity. Astrocytomas and other benign gliomas are less concentrated, often slightly higher than the surrounding brain tissue, and the images are less clear, and some may be negative.  5.Radiological examination includes cranial plain film, ventriculography and computed tomography scan. Cranial plain film can show intracranial pressure increase, tumor calcification and pineal gland calcification displacement, etc. Ventriculography can show cerebral vascular displacement and tumor vascular condition. These abnormal changes, which vary in different types of tumors in different locations, can help localize and sometimes even characterize the tumor. Especially, CT scan has the greatest diagnostic value. Intravenous contrast-enhanced scan has almost 100% accuracy of localization and more than 90% correct rate of qualitative diagnosis. It can show the site, scope, shape, brain tissue reaction and ventricular compression displacement of the tumor. However, it still needs to be considered together with the clinical aspects in order to make a clear diagnosis.  MRI is more accurate and clearer than CT in the diagnosis of brain tumor, and it can find tiny tumors that cannot be shown by CT.  Positron emission tomography can obtain images similar to CT, and can observe the growth and metabolism of tumors and identify benign and malignant tumors.