Enoch D A, Cargill J S, Laing R, Herbert S, Corrah T W, Brown N M
Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK.
J Clin Pathol. 2008 Jun;61(6):750-3. doi: 10.1136/jcp.2007.054296. Epub 2008 Mar 6.
To determine the role of CT-guided biopsy in the management of cases of infective discitis.
Data were examined from a retrospective case series of CT-guided biopsies for the 5-year period ending June 2006.
98 CT-guided biopsies were performed in the study period on 103 patients. Malignancy was diagnosed in 49 episodes. Discitis and paravertebral abscess accounted for 27 cases. Culture was positive in nine of 25 (36%) samples received by the microbiology laboratory. Staphylococcus aureus (four cases) and Mycobacterium tuberculosis (three cases) were the most frequent organisms isolated, followed by group G streptococci and coagulase-negative staphylococci (one case each). Blood cultures were diagnostic in a further nine patients. The main reason for a negative culture was prior antimicrobial therapy. The biopsy changed management in 9/25 (36%) of cases. There were no reported adverse events.
Septic discitis is a serious condition with a wide variety of infective causes. CT-guided biopsy is a useful tool when the diagnosis of infectious spinal infection is considered in terms of commencing and targeting therapy, and it is a safe and well-tolerated procedure.
确定CT引导下活检在感染性椎间盘炎病例管理中的作用。
对截至2006年6月的5年期间CT引导下活检的回顾性病例系列数据进行检查。
在研究期间，对103例患者进行了98次CT引导下活检。49例诊断为恶性肿瘤。椎间盘炎和椎旁脓肿占27例。微生物实验室收到的25份样本中有9份（36%）培养结果呈阳性。分离出的最常见病原体为金黄色葡萄球菌（4例）和结核分枝杆菌（3例），其次是G组链球菌和凝固酶阴性葡萄球菌（各1例）。另有9例患者血培养具有诊断意义。培养结果为阴性的主要原因是先前接受过抗菌治疗。活检改变了25例中的9例（36%）患者的治疗方案。未报告不良事件。
化脓性椎间盘炎是一种病因多样的严重疾病。在考虑开始治疗并确定治疗靶点时，CT引导下活检是诊断感染性脊柱感染的一种有用工具，且该操作安全、耐受性良好。
