Castle Maria, Nájera Edinson, Samprón Nicolas, Bollar Alicia, Urreta Iratxe, Urculo Enrique
Departamento de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
Departamento de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
Neurocirugia (Astur). 2014 Mar-Apr;25(2):56-61. doi: 10.1016/j.neucir.2013.11.003. Epub 2014 Mar 19.
The aim of this study was to evaluate the variables that could modify the diagnostic yield of frameless stereotactic biopsy, as well as its complications.
This was a retrospective study of frameless stereotactic biopsies carried out between July 2008 and December 2011 at Donostia University Hospital. The variables studied were size, distance to the cortex, contrast uptake and location.
A total of 70 patients were included (75 biopsies); 39 males and 31 females with an age range between 39 and 83 years. The total diagnostic yield in our series was 97.1%. For lesions >19mm, the technique offered a sensitivity of 95.2% (95% CI: 86.9-98.4) and specificity of 57.1% (95% CI: 25.0-84.2). The yield was lower for lesions within 17mm of the cortex: sensitivity of 74.6% (95% CI: 62.1-84.7) and specificity of 71.4% (95% CI: 29.0-96.3). Seven (10%) patients developed complications after the first biopsy and none after the second.
The diagnostic yield was lower for lesions less than 2cm in size and located superficially. In this series we did not observe an increased rate of complications after a second biopsy.
本研究旨在评估可能影响无框架立体定向活检诊断率及其并发症的变量。
这是一项对2008年7月至2011年12月在多诺斯蒂亚大学医院进行的无框架立体定向活检的回顾性研究。所研究的变量包括大小、距皮质的距离、对比剂摄取情况和位置。
共纳入70例患者(75次活检);39例男性和31例女性,年龄在39至83岁之间。我们系列研究中的总诊断率为97.1%。对于直径>19mm的病变,该技术的敏感性为95.2%(95%置信区间:86.9 - 98.4),特异性为57.1%(95%置信区间:25.0 - 84.2)。对于距皮质17mm以内的病变,诊断率较低:敏感性为74.6%(95%置信区间:62.1 - 84.7),特异性为71.4%(95%置信区间:29.0 - 96.3)。7例(10%)患者在首次活检后出现并发症,第二次活检后无并发症发生。
对于大小小于2cm且位于浅表的病变,诊断率较低。在本系列研究中,我们未观察到第二次活检后并发症发生率增加。