框架立体定向活检在原发性颅内淋巴瘤诊断中的应用  

Application of frame stereotactic biopsy in the diagnosis of primary intracranial lymphoma

作　　者：李敏 涂斌锋[1] 吕巧莉 钟方平 李东海 李剑斌 LI Min;TU Bin-feng;LYU Qiao-li;ZHONG Fang-ping;LI Dong-hai;LI Jian-bin(Department of Neurosurgery,Jiangxi Provincial Cancer Hospital(the Second Affiliated Hospital of Nanchang Medical College),Nanchang 330029,Jiangxi,China)

机构地区：[1]江西省肿瘤医院神经外科,江西南昌330029 [2]江西省肿瘤医院中心实验室,江西南昌330029

出　　处：《广东医学》2023年第5期617-622,共6页Guangdong Medical Journal

基　　金：江西省卫生健康委员会科技计划项目(202110079)。

摘　　要：目的探讨框架立体定向活检在原发性颅内淋巴瘤诊断中的可行性和安全性,明确框架立体定向活检在原发性淋巴瘤价值,推动原发性颅内淋巴瘤诊断规范化,提高诊断水平。方法回顾性分析术前影像学诊断淋巴瘤患者及术后立体定向活检术后病理诊断淋巴瘤患者,探讨影像学诊断与病理诊断符合率及其局限性,分析立体定向活检操作安全性和可行性。结果纳入研究患者共59例,男36例,女23例,术前影像学诊断淋巴瘤患者共52例,立体定向活检病理确诊46例;术前影像学未诊断淋巴瘤患者中术后立体定向活检病理提示淋巴瘤患者7例,影像学诊断与病理相符合率77.97%。框架脑立体定向并发症主要是出血(9例)、头痛加重(7例)、肢体活动障碍加重(1例)、呕吐(6例)、短暂意识丧失(1例),无颅内感染、死亡病例。出血量2 mL以内6例,2~10mL内2例,10 mL以上1例,均未行开颅手术。手术并发症发生率低且较轻,通过提高手术操作水平能够大幅降低。结论框架立体定向活检是原发性颅内淋巴瘤安全有效诊断方法,能够显著提高诊断水平,提升原发性颅内淋巴瘤诊断准确性。Objective To evaluate the feasibility and safety of frame stereotactic biopsy in the diagnosis of primary intracranial lymphoma,to clarify the value of frame stereotactic biopsy in primary lymphoma,to promote the standardization of the diagnosis of primary intracranial lymphoma,and to improve the level of diagnosis.Methods A retrospective analysis was conducted to investigate the consistency and limitations between preoperative imaging diagnosis and postoperative stereotactic biopsy pathology diagnosis in lymphoma patients,and to analyze the safety and feasibility of stereotactic biopsy.Results A total of 59 patients were included in the study,including 36 males and 23 females.Among the 52 patients diagnosed with lymphoma by preoperative imaging,46 were confirmed by postoperative stereotactic biopsy pathology.Among the 7 patients who were not diagnosed with lymphoma by preoperative imaging,7 were diagnosed by postoperative stereotactic biopsy pathology,resulting in a diagnostic consistency rate of 77.97%between imaging diagnosis and pathology.The main complications of frame-based stereotactic biopsy were bleeding(9 cases),worsened headache(7 cases),limb movement disorder(1 case),vomiting(6 cases),transient loss of consciousness(1 case),intracranial infection(0 cases),and death(0 cases).The amount of bleeding was less than 2 mL in 6 cases,2-10 mL in 2 cases,and more than 10 mL in 1 case,and none of the patients underwent craniotomy.The incidence of surgical complications was low and mild,which could be significantly reduced by improving the level of surgical operations.Conclusion Frame-based stereotactic biopsy is a safe and effective diagnostic method for primary intracranial lymphoma,which can significantly improve the diagnostic level and accuracy of primary intracranial lymphoma.

关 键 词：框架立体定向活检 原发性 颅内淋巴瘤 应用价值 并发症 

分 类 号：R651[医药卫生—外科学] R651.1[医药卫生—临床医学]