Fernandes D S, Aye R W, Garnett D J, Denny J
Department of Surgery, Swedish Medical Center, Seattle, Washington, USA.
Am J Surg. 2000 May;179(5):389-90. doi: 10.1016/s0002-9610(00)00364-0.
Intraoperative localization of rib abnormalities identified on bone scan can be deceptively difficult. Previously used techniques have had limited sensitivity and accuracy. The gamma probe can help localize these bone scan "hot spots."
Over the past 17 months, 5 patients underwent gamma-probe-directed limited rib resections following intravenous administration of Tc99m-MDP. Three patients required biopsies for suspected malignancy, and the other 2 underwent therapeutic resections for pain. The device was easy to work with following minimal training.
Localization was excellent, limiting the extent of surgery needed. Comparison with rib counting and preoperative bone scan localization showed a discrepancy of up to 13 cm. Sensitivity and accuracy were each 100%.
The gamma probe offers a simple and significant advance in the performance of rib biopsies for nonpalpable lesions.
骨扫描发现的肋骨异常在术中定位可能异常困难。以前使用的技术灵敏度和准确性有限。γ探测器有助于定位这些骨扫描“热点”。
在过去17个月中,5例患者在静脉注射Tc99m-MDP后接受了γ探测器引导下的有限肋骨切除术。3例患者因疑似恶性肿瘤需要活检,另外2例因疼痛接受治疗性切除。经过最少的培训后,该设备易于操作。
定位效果极佳,限制了所需手术范围。与肋骨计数和术前骨扫描定位相比,差异高达13厘米。灵敏度和准确性均为100%。
γ探测器在不可触及病变的肋骨活检操作方面提供了一项简单而重大的进展。