CT引导经皮骨穿刺活检术的临床应用  

Clinical application of CT-guided percutaneous biopsy for bone lesions

作　　者：张肖[1] 赵瑞荣[2] 肖越勇[1] 吴斌[1] 刘士榕[1] 马旭阳[1] 

机构地区：[1]中国人民解放军总医院放射科,北京100853 [2]山东省聊城大学医院,山东聊城252000

出　　处：《中国介入影像与治疗学》2010年第2期97-100,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨CT引导下经皮骨穿刺活检技术在骨骼病变中的应用价值。方法回顾性分析于我院接受CT引导下穿刺活检术的857例骨骼病变患者。经扫描定位,按照病灶距离体表最近和安全性原则选择最佳进针层面与路径,采用8～13G骨穿针或16～18G弹枪式活检针,根据病变位置及性质运用不同穿刺技术获取标本行病理学检查。结果操作过程耗时20～40 min。所有患者取得的标本量均符合病理诊断要求,穿刺病理与手术病理相符者766例,占穿刺总数89.38%,无假阳性病例。术后27例患者出现并发症,发生率为3.15%,包括局部血肿22例,神经损伤1例,感染4例。结论经皮骨穿刺活检安全、诊断准确率高,可用于转移性肿瘤、原发性骨肿瘤、肿瘤样病变及炎症性病变的诊断。合理地选择穿刺路径、穿刺器械及活检方法可提高穿刺活检的成功率。Objective To investigate the clinical value of CT-guided percutaneous bone biopsy in skeletal lesions.Methods Totally 857 patients with skeletal lesions who underwent CT-guided percutaneous bone biopsy were analyzed retrospectively.The position and path of puncture were selected according to the adjacent and safety principle after CT localization.Lesions were penetrated with 8—13G bone puncture needles or 16—18G trigger-type biopsy needles for obtaining specimens.Results The whole procedures were generally finished within 20—40 min,and adequate samples were obtained for pathologic examinations in all patients.The pathological findings of biopsy for 766 patients were consistent with that of surgeries（89.38%）.No false positive patient was found.Postoperative complications occurred in 27 patients（3.15%）,including local hematomas in 22 patients,nerve injury in 1 patient and infection in 4 patients.Conclusion CT-guided percutaneous bone biopsy is safe and with high diagnostic accuracy.It can be used to diagnose metastases,primary bone tumors,tumor-like lesions and inflammatory lesions.The reasonable selection of the path of puncture,puncture needles and biopsy methods can improve the success rate of biopsy.

关 键 词：活组织检查 针吸 骨疾病 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R815[医药卫生—放射医学]