Franiel T, Fritzsche F, Staack A, Rost J, Hamm B, Beyersdorff D
Radiologie CCM, Charité, Universitätsmedizin Berlin.
Rofo. 2006 Dec;178(12):1212-8. doi: 10.1055/s-2006-926936. Epub 2006 Aug 25.
The histopathologic quality of core biopsy specimens obtained via MRI-guided prostate biopsy using a 16G MR-compatible needle was compared to that of biopsies obtained via ultrasound-guided biopsy using a conventional 18G stainless steel biopsy needle.
A retrospective analysis was performed for a total of 247 transrectal prostate biopsy specimens obtained from 32 patients. A total of 117 tissue cores were obtained from 15 patients (PSA of 10.8 ng/ml, age 64 years) who underwent an MRI-guided prostate biopsy using a 16G (1.7 mm) MR-compatible biopsy needle made of titanium alloy. The remaining 130 tissue cores were obtained from 17 patients (PSA of 6.7 ng/ml, age 68 years) who underwent a transrectal ultrasound-guided prostate biopsy using an 18G (1.3 mm) ferromagnetic stainless steel biopsy needle. The length and width of the histologic sections prepared from the tissue cores were measured to calculate the area. The histopathologic quality of the specimens was assessed microscopically using tissue fragmentation, the presence of crush artifacts, and the overall accessibility as criteria. Each of these features was assigned a score from 0 to 3. All 3 features contributed equally to the overall score which ranged from 0 (no tissue) to 9 (optimal quality).
The overall quality scores assigned to the biopsies obtained with a 16G MR-compatible needle and an 18G ferromagnetic needle can be considered to be equivalent to a mean difference between patient related median scores of the specimens of - 0.05 (95 % confidence interval [- 0.46; 0.36]) and a given equivalence limit of 1. The MRI biopsies showed more tissue fragmentation (p = 0.001) but fewer crush artifacts (p = 0.022) while the accessibility did not differ significantly between the two needle types (p = 0.064). There was also no significant difference in the calculated areas of the tissue cores (p = 0.236). According to the different calibers of the biopsy needles, the lengths (p = 0.008) and widths (p = 0.000) of the biopsy specimens differed significantly.
The core biopsy specimens obtained with an MR-compatible 16G titanium alloy biopsy needle are of the same histopathologic quality as specimens obtained with a ferromagnetic 18G stainless steel needle.
比较使用16G磁共振兼容穿刺针经磁共振成像（MRI）引导的前列腺穿刺活检获得的核心活检标本的组织病理学质量与使用传统18G不锈钢穿刺针经超声引导的活检标本的组织病理学质量。
对32例患者的247份经直肠前列腺穿刺活检标本进行回顾性分析。15例患者（前列腺特异性抗原[PSA]为10.8 ng/ml，年龄64岁）使用由钛合金制成的16G（1.7 mm）磁共振兼容穿刺针进行MRI引导的前列腺穿刺活检，共获得117条组织芯。其余130条组织芯来自17例患者（PSA为6.7 ng/ml，年龄68岁），他们使用18G（1.3 mm）铁磁性不锈钢穿刺针进行经直肠超声引导的前列腺穿刺活检。测量从组织芯制备的组织切片的长度和宽度以计算面积。以组织破碎、挤压伪像的存在以及总体可获取性为标准，通过显微镜评估标本的组织病理学质量。这些特征中的每一个都给予0至3分。所有这3个特征对总分的贡献相同，总分范围为0（无组织）至9（最佳质量）。
使用16G磁共振兼容穿刺针和18G铁磁性穿刺针获得的活检标本的总体质量得分可认为是等效的，患者相关标本中位数得分之间的平均差异为 - 0.05（95%置信区间[- 0.46; 0.36]），给定等效限为1。MRI活检显示更多的组织破碎（p = 0.001）但挤压伪像更少（p = 0.022），而两种穿刺针类型之间的可获取性没有显著差异（p = 0.064）。组织芯的计算面积也没有显著差异（p = 0.236）。根据穿刺针的不同口径，活检标本的长度（p = 0.008）和宽度（p = 0.00)）有显著差异。
使用16G磁共振兼容钛合金穿刺针获得的核心活检标本与使用铁磁性18G不锈钢穿刺针获得的标本具有相同的组织病理学质量。
