应用立体定向技术诊断下丘脑病变  

Stereotactic biopsy used in the diagnosis of hypothalamus lesions

作　　者：黄杉[1] 吴瀚峰[3] 鹿斌[1] 张朝云[1] 周丽诺[1] 程海霞[2] 李益明[1] 胡仁明[1] 汪寅[2] 潘力[3] 叶红英[1] 

机构地区：[1]复旦大学附属华山医院内分泌代谢病科,上海200040 [2]复旦大学附属华山医院神经病理室,上海200040 [3]复旦大学附属华山医院一上海伽玛医院神经外科

出　　处：《中华内分泌代谢杂志》2013年第11期935-939,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：985项目（985Ⅲ-YFX0302,985Ⅲ-EZF157101复旦大学）：上海市科委重点项目（11411951900）

摘　　要：目的分析和讨论立体定向穿刺活检技术在下丘脑病变诊断中的应用，为疑难病例提供诊断手段。方法分析和总结2例临床表现为下丘脑综合征，影像学显示为下丘脑占位的患者，经立体定向穿刺活检明确病理诊断。结果2例患者均未发生穿刺相关并发症，分别明确诊断为下丘脑炎性肉芽肿和胚胎生殖细胞肿瘤。给予相应的治疗后其症状及影像学均获得不同程度的改善。复习2001年后文献中报道行立体定向穿刺活检的病例，其成功率为86％～99％，活检病理与手术病理的一致率为79％．96．7％，其并发症总体发生率〈5％。结论立体定向穿刺创伤小、准确率高，有利于及早明确下丘脑占位病变性质，为后续治疗提供方案。Objective To analyze the use of stereotactic biopsy in the diagnosis of hypothalamus lesions, which could be an alternative method for cases with diagnostic problems. Methods Two cases of hypothalamus syndrome with a mass in the area of hypothalamus were presented. By image-guided stereotactic biopsy, correct diagnosis was made. Results These 2 cases diagnosed was granulomatous inflammation and embryonic germ cell tumor respeetively, without any biopsy-related complications. The features of disease were improved after corresponding treatment. Similar reports published since 2001 were then reviewed. 86%-99% patients can be diagnosed pathologically by stereotactic biopsy, with accuracy rates of 79%-96.7%. The overall biopsy-related complications were found in less than 5 % of total patients. Conclusions Stereotactic biopsy is a safe and reliable way for making pathological diagnosis and may help selecting appropriate management for hypothalamus lesions.

关 键 词：下丘脑占位 立体定向活检 病因诊断 

分 类 号：R742.89[医药卫生—神经病学与精神病学]