DelGaudio J M, Dillard D G, Albritton F D, Hudgins P, Wallace V C, Lewis M M
Department of Otolaryngology--Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA.
Arch Otolaryngol Head Neck Surg. 2000 Mar;126(3):366-70. doi: 10.1001/archotol.126.3.366.
To evaluate the diagnostic efficacy of computed tomography (CT)-guided needle biopsies of head and neck lesions.
All CT-guided needle biopsies of head and neck lesions performed between September 1994 and February 1999 were included. Cytopathologic and histologic records, along with patient clinical records, were reviewed.
A tertiary care medical center.
Patients referred for evaluation of lesions inaccessible to routine methods of needle biopsy.
Thirty-seven patients underwent 42 CT-guided biopsies. There were included 12 lesions in or adjacent to the skull base and 9 lesions around the pharyngoesophageal or laryngotracheal complex; the other lesions were located in the deep lobe of the parotid gland (n = 7), deep neck area (n = 12), and thyroid gland (n = 2). Diagnostic cytologic biopsy specimens were obtained in 38 (91%) of 42 needle biopsy procedures. The results were supported histologically and/or clinically in 36 cases (95%). Eighteen patients underwent open surgical procedures. Histologic confirmation was found in 86% of cases. Nineteen patients (51%) avoided an open surgical procedure: 11 with benign disease and 8 with recurrent malignancy. There were no false-positive or false-negative results, and no complications were identified.
Computed tomography-guided needle biopsy is a safe and reliable minimally invasive technique for the diagnosis of poorly accessible or deep-seated lesions of the head and neck. Diagnostic needle biopsies allow improved preoperative planning and patient counseling in surgical patients and avoidance of open surgical procedures in patients with benign disease or recurrent malignant neoplasms.
评估计算机断层扫描（CT）引导下的头颈部病变穿刺活检的诊断效能。
纳入1994年9月至1999年2月期间所有在CT引导下进行的头颈部病变穿刺活检。回顾细胞病理学和组织学记录以及患者临床记录。
一家三级医疗中心。
因常规穿刺活检方法难以触及的病变而转诊评估的患者。
37例患者接受了42次CT引导下的活检。其中包括12例颅底或其附近的病变，9例咽食管或喉气管复合体周围的病变；其他病变位于腮腺深叶（n = 7）、颈部深部区域（n = 12）和甲状腺（n = 2）。42次穿刺活检操作中有38次（91%）获得了诊断性细胞活检标本。36例（95%）的结果得到了组织学和/或临床的支持。18例患者接受了开放性手术。86%的病例得到了组织学证实。19例患者（51%）避免了开放性手术：11例为良性疾病，8例为复发性恶性肿瘤。没有假阳性或假阴性结果，也未发现并发症。
CT引导下的穿刺活检是一种安全可靠的微创技术，用于诊断头颈部难以触及或深部的病变。诊断性穿刺活检有助于改善手术患者的术前规划和患者咨询，并避免良性疾病或复发性恶性肿瘤患者进行开放性手术。
