Daecke W, Libicher M, Mädler U, Rumpf C, Bernd L
Stiftung Orthopädische Universitätsklinik Heidelberg.
Orthopade. 2003 Feb;32(2):170-4. doi: 10.1007/s00132-002-0381-2.
MRI-guided musculoskeletal biopsy has been mentioned to be a minimally invasive method to obtain specimens for diagnostic purposes in bone tumors. To evaluate the viability, to assess the accuracy, and to record possible complications of this method, clinical data of 19 MRI-guided biopsies were analyzed. Interventions were performed on 18 patients (1-78 years) as an outpatient procedure: 15 skeletal and 4 soft tissue biopsies were taken from the pelvis, upper limb,or lower limb. We used T1-weighted gradient echoes (GE) for locating the puncture site and T2-weighted turbo spin echoes (TSE) for visualization of needle position. In 14 of 18 MRI-guided biopsies, a definite histological diagnosis was obtained. According to the pathologist, the inadequate size of the specimen was the main reason for missing the diagnoses in four cases.Long intervention time and inappropriate biopsy tools proved to be the main disadvantages of MRI-guided biopsy, but technical improvement might solve these technical problems in future.A postbiopsy hematoma was the only complication observed. Once technically improved, MRI-guided biopsy could be a precise alternative routine method for musculoskeletal biopsies in future.
磁共振成像(MRI)引导下的肌肉骨骼活检被认为是一种微创方法,可用于获取骨肿瘤诊断所需的标本。为了评估该方法的可行性、准确性并记录可能出现的并发症,我们分析了19例MRI引导下活检的临床数据。对18例患者(年龄1至78岁)进行了门诊手术干预:从骨盆、上肢或下肢获取了15例骨骼活检和4例软组织活检。我们使用T1加权梯度回波(GE)来定位穿刺部位,并使用T2加权快速自旋回波(TSE)来观察针的位置。在18例MRI引导下的活检中,有14例获得了明确的组织学诊断。根据病理学家的说法,标本尺寸不足是4例未能确诊的主要原因。干预时间长和活检工具不合适被证明是MRI引导下活检的主要缺点,但技术改进可能在未来解决这些技术问题。活检后血肿是观察到的唯一并发症。一旦技术得到改进,MRI引导下活检未来可能成为肌肉骨骼活检的一种精确的替代常规方法。