Peh Wcg
Programme Office, Singapore Health Services, Singapore.
Biomed Imaging Interv J. 2006 Jul;2(3):e25. doi: 10.2349/biij.2.3.e25. Epub 2006 Jul 1.
Accurate diagnosis of spine lesions is important for its successful management. Imaging-guided percutaneous biopsy is gaining increasing acceptance as a means for obtaining tissue for diagnosis. Most biopsies can be rapidly performed under local anaesthesia, with little patient discomfort and improved safety. Spinal anatomy is, however, complex with many adjacent vital structures. Good knowledge of anatomy and precise needling technique is, therefore, important. Today, biopsy of spinal lesions is best performed under computed tomography (CT) fluoroscopic guidance. Indications for imaging-guided biopsy include confirming metastasis in a patient with a known primary tumour, determining the nature of a solitary bone lesion, excluding malignancy in vertebral body compression, and investigating for infection. Among the various issues to be considered are site of lesion, location of adjacent vital structures, approach, and type and size of needle. Complications are rare, particularly when a meticulous technique is applied. In summary, CT-guided percutaneous biopsy is a safe and an effective technique for the evaluation of spinal lesions and useful in planning therapy.
准确诊断脊柱病变对其成功治疗至关重要。影像引导下经皮穿刺活检作为获取组织进行诊断的一种手段，越来越被广泛接受。大多数活检可在局部麻醉下迅速完成，患者不适少且安全性提高。然而，脊柱解剖结构复杂，有许多相邻的重要结构。因此，熟悉解剖结构和掌握精确的穿刺技术很重要。如今，脊柱病变活检最好在计算机断层扫描（CT）透视引导下进行。影像引导活检的适应证包括在已知原发性肿瘤患者中确认转移、确定孤立性骨病变的性质、排除椎体压缩中的恶性肿瘤以及调查感染情况。需要考虑的各种问题包括病变部位、相邻重要结构的位置、穿刺路径以及针的类型和尺寸。并发症很少见，尤其是当采用细致的技术时。总之，CT引导下经皮穿刺活检是评估脊柱病变的一种安全有效的技术，对治疗方案的制定很有帮助。
