Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS, Finland.
Eur J Radiol. 2013 Dec;82(12):2328-33. doi: 10.1016/j.ejrad.2013.09.005. Epub 2013 Sep 18.
The purpose of this study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) guided musculoskeletal biopsy and the value of fine needle aspiration biopsy (FNAB) when combined with histologic biopsy.
A total of 172 biopsies were performed under MRI guidance, 170 were histologic biopsies. In 112 cases, a fine needle aspiration biopsy was also performed. In two cases, a stand-alone FNAB was performed. The diagnostic performance was evaluated retrospectively by comparing the histopathologic and cytologic diagnosis with the current or final diagnosis after at least one year of clinical and imaging follow-up. A 0.23 T open MRI scanner with an interventional stereotactic guidance system was used.
The overall diagnostic accuracy of MRI guided biopsy was 0.95, sensitivity 0.91, specificity 0.98, positive predictive value (ppv) 0.97 and negative predictive value (npv) 0.93. The diagnostic accuracy of trephine biopsy alone was 0.93, sensitivity 0.89, specificity 0.98, ppv 0.97 and npv 0.91 and accuracy for FNAB alone was 0.85, sensitivity 0.80, specificity 0.90, ppv 0.89 and npv 0.82.
MRI guidance is a feasible and accurate tool in percutaneous musculoskeletal biopsies. Fine needle biopsy is a useful low-cost supplement to histologic biopsy.
本研究旨在评估磁共振成像（MRI）引导下肌肉骨骼活检的诊断性能，以及在与组织学活检联合使用时细针抽吸活检（FNAB）的价值。
共在 MRI 引导下进行了 172 次活检，其中 170 次为组织学活检。在 112 例中，还进行了细针抽吸活检。在 2 例中，仅进行了 FNAB。通过将组织病理学和细胞学诊断与至少一年的临床和影像学随访后的当前或最终诊断进行比较，回顾性评估诊断性能。使用 0.23 T 开放式 MRI 扫描仪和介入式立体定向引导系统。
MRI 引导活检的总体诊断准确性为 0.95，灵敏度为 0.91，特异性为 0.98，阳性预测值（PPV）为 0.97，阴性预测值（NPV）为 0.93。单独使用环钻活检的诊断准确性为 0.93，灵敏度为 0.89，特异性为 0.98，PPV 为 0.97，NPV 为 0.91，单独使用 FNAB 的准确性为 0.85，灵敏度为 0.80，特异性为 0.90，PPV 为 0.89，NPV 为 0.82。
MRI 引导是经皮肌肉骨骼活检的一种可行且准确的工具。细针活检是组织学活检的一种有用的低成本补充。
