Preteseille O, Barral F G, Court L, Russias B, Manet L, Tanji P, Mosnier J F, Fessy M H, Thomas T
Service de radiologie, Hôpital Bellevue, CHU Saint Etienne, France.
J Radiol. 2003 Jun;84(6):693-7.
To Determine the value of percutaneous core needle biopsy in the investigation of a suspected bone neoplasm.
We performed a retrospective study of 91 core needle biopsies performed between May 1995 and October 2001. Patients were excluded if they had a known primary carcinoma or if an infection was suspected by clinical, physical or laboratory findings. The results were correlated to the analysis of the surgical piece or, for the 28 patients who did not undergo surgery, to the clinical evolution over more than 12 months.
The final diagnosis was metastasis in 29 cases, primary bone tumor in 36 cases and benign lesions in 25 cases. Sensitivity was 92.3% and specificity was 97.4%. For primary malignant bone tumors, results respected histology features and grade in 79.2%. In cases of mistake, because of the correlation of these results to the clinical and radiological context, the treatment of the bony malignant lesions were adapted in 95.8% of cases. Only one major complication was reported in these 91 biopsies.
First intention core needle biopsy, confronted with radio-clinical context seems to have a place in the evaluation of bone lesions when a tumor is suspected. This technique, less expensive than an open biopsy and with fewer complications, is best performed as part of a multidisciplinary approach with the surgeon's collaboration.
确定经皮芯针活检在疑似骨肿瘤检查中的价值。
我们对1995年5月至2001年10月期间进行的91例芯针活检进行了回顾性研究。如果患者已知患有原发性癌，或根据临床、体格检查或实验室检查结果怀疑有感染，则将其排除。将结果与手术标本的分析结果相关联，对于28例未接受手术的患者，则与超过12个月的临床病程相关联。
最终诊断为转移瘤29例，原发性骨肿瘤36例，良性病变25例。敏感性为92.3%，特异性为97.4%。对于原发性恶性骨肿瘤，79.2%的结果符合组织学特征和分级。在出现错误的病例中，由于这些结果与临床和放射学背景相关，95.8%的骨恶性病变病例调整了治疗方案。在这91例活检中仅报告了1例主要并发症。
在怀疑有肿瘤时，结合放射学和临床背景的初次芯针活检似乎在骨病变评估中占有一席之地。这项技术比开放活检成本更低，并发症更少，最好在外科医生的协作下作为多学科方法的一部分来进行。
