Melikian A G, Golanov A V, Kasumova S Iu, Kachkov I A, Lobanov S A, Arkhipova N A
Zh Vopr Neirokhir Im N N Burdenko. 1991 Sep-Oct(5):12-7.
CT-stereotaxic biopsy is a modern method for the diagnosis of intracranial tumors. The histological diagnosis established by means of it makes it possible to choose the most rational tactics of treatment and determine more exactly the indications and contraindications for the operation. The examination was conducted on 219 patients with various brain tumors. Authentic histological information was obtained in 84% of cases, 4 patients died, a stable neurological defect developed in another 2 patients. Some methodical procedures for increasing the informativeness and reducing the risk of complications are discussed. An important component is rapid examination of part of the bioptic material by means of smears for intraoperative appraisal of its representativeness and correction of biopsy targets. Among 73 cases in which smears were examined only in 9 the findings were in disagreement with the data of the traditional histologic study, only in the degree of tumor differentiation in all of them. Stereotaxic biopsy is most expedient in situations in which the tactics and main method of treatment are determined to a greater degree by the histological structure rather than by the localization and the patient's general condition. Such cases account for one fourth of all cases of intracerebral tumors.
CT立体定向活检是诊断颅内肿瘤的一种现代方法。通过它建立的组织学诊断能够选择最合理的治疗策略,并更准确地确定手术的适应证和禁忌证。对219例患有各种脑肿瘤的患者进行了该项检查。84%的病例获得了可靠的组织学信息,4例患者死亡,另外2例出现了稳定的神经功能缺损。文中讨论了一些提高信息量和降低并发症风险的方法步骤。一个重要组成部分是通过涂片快速检查部分活检材料,以便术中评估其代表性并校正活检靶点。在73例仅对9例进行涂片检查的病例中,检查结果与传统组织学研究数据不一致,仅在所有病例的肿瘤分化程度方面存在差异。立体定向活检在治疗策略和主要治疗方法在很大程度上由组织结构而非肿瘤定位和患者一般状况决定的情况下最为适用。此类病例占所有脑内肿瘤病例的四分之一。