CT引导下经皮穿刺活检对脊柱病变的诊断价值评价  

To evaluate the diagnostic value of CT-guided percutaneous biopsy of the spinal lesion

作　　者：曹爱红[1] 王绪[2] 杨欣[2] 刘亮[2] 

机构地区：[1]东南大学附属中大医院放射科,210006 [2]徐州医学院第二附属医院影像中心

出　　处：《中国CT和MRI杂志》2008年第5期1-3,共3页Chinese Journal of CT and MRI

摘　　要：目的评价CT引导下经皮穿刺活检对脊柱病变的诊断价值。方法2003年10月～2006年12月期间对临床不能明确诊断的98例脊柱疾患患者行CT引导下椎体穿刺活检术,在CT扫描监控下,使用MANAN-PRO-MAG2.2骨活检针(14G长97mm和110mm)与配套的MDTECH自动切割活检针(16G-18G,长度为10-15cm,切割槽长度为20mm),局麻下取椎体病变骨质适量,通过变换工作通道方向或用较长的骨活检针进行多向取材,将钻取标本立即置入10%福尔马林中保存,标本送病理检查,与相应的病理细胞学检查。结果病灶刺中率100%,穿刺活检病理结果93例获得明确诊断,5例诊断不明确或误诊。穿刺活检总的诊断准确率94.9%,其中转移癌、原发恶性肿瘤和良性病变诊断准确率分别为97.3%(36/37)、83.3%(25/30)和87.1%(27/31)。结论CT引导下穿刺活检术对于脊柱病变具有刺中率高、活检阳性率高、损伤小、并发症少等优点,且只需局部麻醉即可完成操作,为确诊脊柱病变的理想方法,对指导治疗有重要意义。Objective The purpose of this study was to evaluate the diagnostic significance of CT guided percutaneous biopsy of spinal lesion. Methods Between October 2003 and December 2006, 98 cases of patients of vertebral which not on the clinical diagnosis, including 4 case of cervical vertebrae, 40 cases of thoracic vertebrae, 45 cases of lumbar vertebra, 8 cases of sacrum, CT-guided biopsies of spinal lesion were perfomed on 98 patients under local anesthesia. After supine or prone posistioning, CT scan was performed with a 2 mm thickness and a 5 mm interval. The spinal lesion was punctured, using intermittent CT monitoring. Tissue samples were taken to Pathology Department in 10% formalin solution and studied pathologic-cytologically. Results The puncture accuracy was 100%, the general diagnostic accuracy was 94. 9%（ 93/98 ）, in which the diagnostic accuracies of metastasis lesion, primary bone tumor and benign lesion were 97.3% （ 36/37 ）, 83.3 % （ 25/30 ） and 87.1% （ 27/31 ） respectively. Conclusion CT guided percutaneous biopsy is a safe and accurate method with little trauma and complication, having great value in deciding treatment of spinal lesion.

关 键 词：计算机断层扫描 脊柱 活组织检查 

分 类 号：R445.2[医药卫生—影像医学与核医学] R576[医药卫生—诊断学]