Winkler Dirk, Lindner Dirk, Geiger Kathrin, Richter Andreas, Schober Ralf, Meixensberger Jürgen
Klinik und Poliklinik für Neurochirurgie, Universität Leipzig, Deutschland.
Wien Med Wochenschr. 2005 Aug;155(15-16):354-9. doi: 10.1007/s10354-005-0198-9.
A total of 79 patients with a suspect space occupying intracranial lesion was operated stereotactically. After CT and MR image acquisition, entry and target coordinates were defined and biopsy trajectories were simulated preoperatively using a special planning software. Biopsy specimens allowed a satisfactory neuropathological examination and diagnostic result in 74 of 79 (93.7%) cases. In the remaining 5 of 79 (6.3%) patients, a glioses was diagnosed in three cases; in only two patients could no pathological process be proved. 10 of 79 (12.7%) patients showed an intraoperative bleeding out of the biopsy-cannula during serial stereotaxy, which was associated with a CT-detectable hematoma up to 7 mm in diameter in only three cases (3.8%). In no patient was the detection of intracerebral bleeding the reason for any neurological deficit. In summary, the high percentage of satisfactory neuropathological diagnoses, the low rate of stereotaxy-associated morbidity and the comfortable and safe use of computer and stereotactic devices justify this kind of minimally invasive diagnostic measure as a routine method.
共有79例颅内占位性病变疑似患者接受了立体定向手术。在进行CT和MR图像采集后,确定穿刺点和靶点坐标,并术前使用特殊的规划软件模拟活检路径。79例患者中的74例(93.7%)活检标本获得了满意的神经病理学检查结果和诊断结果。在其余79例中的5例(6.3%)患者中,3例诊断为胶质增生;仅2例患者未能证实存在病理过程。79例患者中有10例(12.7%)在连续立体定向活检过程中出现活检针道内术中出血,其中仅3例(3.8%)出现直径达7mm的CT可检测血肿。无一例患者因脑内出血而出现任何神经功能缺损。总之,满意的神经病理学诊断比例高、立体定向相关发病率低以及计算机和立体定向设备使用舒适安全,证明这种微创诊断措施可作为一种常规方法。