Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HLA7 4LP, UK.
Skeletal Radiol. 2013 Jan;42(1):85-90. doi: 10.1007/s00256-012-1452-z. Epub 2012 Jun 12.
To assess the diagnostic yield and diagnostic accuracy of image-guided percutaneous needle biopsy of rib lesions and to analyse the diagnostic spectrum of rib lesions referred to a tertiary musculoskeletal oncology centre.
A retrospective review of all patients that underwent image-guided rib biopsy and/or excision during the period from 1 January 2003 to 31 July 2011. A total of 51 consecutive subjects were identified and included in this study. Image-guided percutaneous biopsy was performed using either CT (n = 43) or ultrasound (n = 8).
There were 28 males and 23 females, with a mean age of 49.9 years (range 10-84 years). Forty-five of the 51 biopsies (88%) yielded a diagnostic sample, and 6 (12%) were non-diagnostic. Thirty-one of 45 (69%) lesions were malignant, and 14 (31%) were benign. The commonest malignant lesions were metastases, 16 of 31 (51.6%), and primary bone or cartilaginous tumours, 15 of 31 (48.4%). The commonest benign lesion was fibrous dysplasia (6 of 14, 43%) followed by infection (5 of 14, 36%). All non-diagnostic samples were from lesions which had no extra-osseous component, and all were subsequently confirmed as benign on rib resection. There was complete agreement between needle and surgical resection in 18 of 19 subjects (96%).
Image-guided percutaneous rib biopsy has high diagnostic yield and accuracy. Intra-osseous lesions which have no associated extra-osseous component have a lower biopsy success rate.
评估经皮引导下肋骨病变穿刺活检的诊断率和诊断准确性，并分析转诊至三级肌肉骨骼肿瘤中心的肋骨病变的诊断谱。
回顾性分析 2003 年 1 月 1 日至 2011 年 7 月 31 日期间所有接受过经皮引导下肋骨活检和/或切除的患者。共确定了 51 例连续患者，并将其纳入本研究。使用 CT（n=43）或超声（n=8）进行经皮引导下穿刺活检。
28 例为男性，23 例为女性，平均年龄为 49.9 岁（范围为 10-84 岁）。51 例活检中，45 例（88%）获得了诊断性样本，6 例（12%）为非诊断性。45 例中有 31 例（69%）为恶性病变，14 例（31%）为良性病变。最常见的恶性病变为转移瘤，31 例中有 16 例（51.6%），其次为原发性骨或软骨肿瘤，31 例中有 15 例（48.4%）。最常见的良性病变为纤维结构不良（14 例中的 6 例，43%），其次为感染（14 例中的 5 例，36%）。所有非诊断性样本均来自无骨外成分的病变，所有病变在肋骨切除后均被证实为良性。在 19 例中有 18 例（96%）活检和手术切除结果完全一致。
经皮引导下肋骨活检具有较高的诊断率和准确性。无骨外成分的骨内病变活检成功率较低。
