Derry Kendra L, Nicolle Michael N, Keith-Rokosh Julia A, Hammond Robert R
Department of Pathology (Neuropathology), London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada.
Can J Neurol Sci. 2009 Mar;36(2):201-6. doi: 10.1017/s0317167100006569.
In the present study we review our experience with 900 consecutive percutaneous muscle biopsies over the period 1993 to 2007. We examined the advantages and limitations of the procedure, biopsy site preferences, diagnostic range, frequency of diagnoses and quality of histopathology. Demographics, referral patterns and patients' perceptions of the procedure were also assessed.
Cases were identified through the London Health Sciences Centre Department of Pathology database. Standard biopsy procedures were followed using a manual trocar style instrument. With a neuropathology technologist in attendance at all biopsies, biopsies were oriented in the fresh state and snap frozen.
Most referrals for muscle biopsy were from neuromuscular neurologists. The procedure was found to be efficient, well-tolerated and produced high quality specimens in all diagnostic categories. No major complications occurred. Failure to obtain an adequate tissue sample, although uncommon (< 2%), was usually due to marked obesity, edema or muscle wasting. Bleeding at the site was rarely problematic and no wound infections were reported.
Needle muscle biopsies represent an efficient alternative to open biopsies when peripheral nerve sampling is not required and when large tissue samples are not needed for extensive biochemical analyses.
在本研究中,我们回顾了1993年至2007年期间连续900例经皮肌肉活检的经验。我们研究了该操作的优点和局限性、活检部位偏好、诊断范围、诊断频率以及组织病理学质量。还评估了人口统计学、转诊模式以及患者对该操作的看法。
通过伦敦健康科学中心病理科数据库识别病例。采用手动套管针式器械遵循标准活检程序。在所有活检过程中均有神经病理学技术人员在场,活检标本在新鲜状态下进行定向并速冻。
大多数肌肉活检转诊来自神经肌肉科神经学家。该操作被发现是高效的,耐受性良好,并且在所有诊断类别中都能产生高质量的标本。未发生重大并发症。未能获取足够的组织样本,虽然不常见(<2%),但通常是由于明显肥胖、水肿或肌肉萎缩。活检部位出血很少造成问题,且未报告伤口感染。
当不需要进行周围神经采样且不需要大的组织样本进行广泛的生化分析时,针吸肌肉活检是开放活检的一种有效替代方法。