Gupta S, Takhtani D, Gulati M, Khandelwal N, Gupta D, Rajwanshi A, Gupta S, Suri S
Department of Radiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Clin Ultrasound. 1999 Mar-Apr;27(3):123-9. doi: 10.1002/(sici)1097-0096(199903/04)27:3<123::aid-jcu4>3.0.co;2-1.
We report the use of sonography to guide fine-needle aspiration biopsies (FNABs) of lytic lesions of the spine.
Twenty-nine patients with lytic vertebral lesions with or without associated extraosseous soft-tissue extension underwent sonographically guided FNAB. Twelve cervical, 7 thoracic, 7 lumbar, and 3 sacral lesions were biopsied. Tissue samples were taken from either the bony lesion through a break in the cortex (n = 9) or the associated soft-tissue extension (n = 20).
Adequate diagnostic material obtained in 27 cases (93%) revealed an inflammatory (n = 13) or malignant process (n = 14). Of the 2 patients with inconclusive FNAB findings, 1 patient was lost to follow-up, and the other underwent surgery, which revealed tuberculosis. No complications of FNAB were encountered.
We conclude that sonography is a safe and effective guidance modality for FNAB of lytic lesions of the spine, especially for lesions in the cervical region. In the thoracic, lumbar, and sacral regions, however, the role of sonographically guided FNAB is limited to lesions affecting the posterior elements.
