Bueno Horcajadas Á, Martel Villagrán J
Servicio de Diagnóstico por Imagen, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
Radiologia. 2012 Sep;54 Suppl 1:27-37. doi: 10.1016/j.rx.2012.07.001. Epub 2012 Sep 5.
The prognosis of musculoskeletal sarcomas is related to appropriate management by specifically trained multidisciplinary teams. Musculoskeletal radiologists are responsible for the image-guided percutaneous biopsy of these tumors, which has a diagnostic accuracy of at least 80%. It is essential for radiologists to know: a) the limitations of percutaneous biopsy with respect to surgical biopsy; b) what should and should not be biopsied; c) how to appropriately plan percutaneous biopsy, with special attention to the route of approach, taking into account the compartmental anatomy and the route of approach after surgical treatment; and d) technical aspects of the procedure, like the area of the tumor to biopsy, the caliber of the needle, the number and length of the specimens to obtain to ensure optimal pathological diagnosis, and techniques in function of the imaging modality and bone penetration.
肌肉骨骼肉瘤的预后与经过专门培训的多学科团队的恰当管理有关。肌肉骨骼放射科医生负责对这些肿瘤进行影像引导下的经皮活检,其诊断准确率至少为80%。放射科医生必须了解:a)经皮活检相对于手术活检的局限性;b)哪些应该活检以及哪些不应该活检;c)如何合理规划经皮活检,尤其要注意进针途径,同时考虑到分区解剖结构以及手术治疗后的进针途径;d)该操作的技术要点,如活检的肿瘤区域、针的口径、获取标本的数量和长度以确保获得最佳病理诊断,以及根据成像方式和骨质穿透情况的技术。