非强化脑病变立体定向活检诊断影响因素分析  

Factors affecting diagnostic yield of stereotactic biopsy in non-enhancement brain lesions

作　　者：赵思源[1] 张剑宁[1] 常洪波[1] 孙艳杰[1] 刘娟 尹丰[1] 田增民[1] 

机构地区：[1]第二军医大学海军临床医学院(海军总医院)神经外科,北京100048 [2]第二炮兵总医院血液病移植科,北京100088

出　　处：《中华神经外科疾病研究杂志》2015年第3期242-246,共5页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的：分析MRI检查非强化脑内病变立体定向活检诊断率的影响因素。方法对92例非强化脑内病变的患者行MRI引导的立体定向活检手术，总结其临床表现、病变特点、病理诊断及术后并发症，分析影响活检诊断率的因素。结果77例获得明确的病理诊断，活检诊断率为83．7％，并发症发生率为2．2％，多因素Logistic回归分析提示浅部（皮层）病灶活检诊断率显著低于深部（非皮层）病灶（优势比（OR）为3．937；95％可信区间为1．224～12．662；P＜0．05），其他因素与活检诊断率无明显相关性。结论立体定向活检术有助于明确脑内非强化病变的病理性质。病灶深度对活检诊断率有显著影响，皮层病灶诊断率较低。Objective The factors affecting diagnostic yield of stereotactic biopsy in non-enhancement brain lesions are discussed.Methods Ninety-two patients with non-enhancement brain lesions underwent MRI-guided stereotactic biopsy.Clinical features, lesion characteristics, pathological diagnosis and post-operative complications were summarized.The factors affecting diagnostic yield were analyzed.Results Seventy-seven patients had definitive pathological diagnoses.The diagnostic yield in this series was 83.7%. The procedure-related complication morbidity was 2.2%.Multivariate Logistic regression analysis showed that the biopsy diagnostic yield of superficial （ cortical） lesions was significantly decreased compared to that of deep （non-cortical） lesions （odds ratio （OR）：3.937;95%confidence interval：1.224～12.662;P〈0.05）.The other factors did not significantly correlate with the diagnostic yield.Conclusion Stereotactic biopsy is advantageous to obtain accurate pathological diagnosis of non-enhancement brain lesions.The diagnostic yield of cortical lesions is lower than that of non-cortical lesions.

关 键 词：立体定向技术 活检 脑疾病 磁共振成像 

分 类 号：R651.11[医药卫生—外科学]