Yu X, Liu Z, Tian Z, Li S, Huang H, Xiu B, Zhao Q, Liu L, Jing W
Department of Neurosurgery, Navy General Hospital of PLA, Beijing, China.
Stereotact Funct Neurosurg. 2000;75(2-3):103-8. doi: 10.1159/000048390.
To investigate the role of stereotactic biopsy in planning the optimal management of intracranial space-occupying lesions.
Between December 1989 and December 1999, stereotactic biopsy was performed in 550 patients with intracranial mass lesions that were deep-seated or located in the functional area. There were 340 males and 210 females, and their ages ranged from 4 to 75 years. All the procedures were done under local anesthesia with a Leksell stereotactic system. A CT scan was used to determine the coordinates in the first 420 cases and the Aero Tech Stereotactic Surgical Plan System in the subsequent 130 patients.
Brain tumors were diagnosed pathologically in 475 patients (86.4%), inflammatory process in 44 (8.0%), other lesions in 12 (2.2%) and no conclusive diagnosis was found in 19 (3.4%). The overall positive rate of biopsy was 96.6%, and the positive rate for brain tumor was 86.4%. Intracranial hematomas after biopsy were found in 13 cases (2.4%). Seizures occurred during the operation in 7 cases (1.2%), and slight and transient neurological deficits were found in 23 cases (4.2%). There were no deaths or other serious complications.
The results suggest that the stereotactic biopsy is a reliable method to obtain histopathological diagnosis of intracranial mass lesions, and it is also of great help in selecting the appropriate management.
探讨立体定向活检在规划颅内占位性病变最佳治疗方案中的作用。
1989年12月至1999年12月期间，对550例颅内深部或位于功能区的占位性病变患者进行了立体定向活检。其中男性340例，女性210例，年龄4至75岁。所有手术均在局部麻醉下使用Leksell立体定向系统进行。前420例患者通过CT扫描确定坐标，后130例患者使用Aero Tech立体定向手术规划系统。
475例（86.4%）患者经病理诊断为脑肿瘤，44例（8.0%）为炎症性病变，12例（2.2%）为其他病变，19例（3.4%）未得出明确诊断。活检总体阳性率为96.6%，脑肿瘤阳性率为86.4%。活检后发生颅内血肿13例（2.4%）。术中发生癫痫7例（1.2%），出现轻微且短暂神经功能缺损23例（4.2%）。无死亡或其他严重并发症发生。
结果表明，立体定向活检是获取颅内占位性病变组织病理学诊断的可靠方法，对选择合适的治疗方案也有很大帮助。
