Ishikawa Eiichi, Yamamoto Tetsuya, Matsuda Masahide, Akutsu Hiroyoshi, Zaboronok Alexander, Kohzuki Hidehiro, Miki Shunichiro, Takano Shingo, Matsumura Akira
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Surg Neurol Int. 2015 Sep 18;6:149. doi: 10.4103/2152-7806.165764. eCollection 2015.
The authors report a continuous case series of navigation-guided rigid endoscopic biopsy via the transcortical route for intraparenchymal brain lesions to assess the feasibility and efficacy of the method.
Thirty-four patients with intraparenchymal brain lesions found on neurovisualization underwent navigation-guided rigid endoscopic biopsy. Most of the preoperative diagnoses were glioma WHO Grade II-IV (16 cases) or malignant lymphoma (15 cases). Intraoperative photodynamic diagnosis and intraoperative pathological diagnosis were used in 28 and 29 cases, respectively. In 2 cases with small and deep lesions, intraoperative magnetic resonance imaging was used for confirming the accuracy of the biopsy point.
The sampling accuracy determined by postoperative imaging and the definitive diagnosis ratio were 94% (32 out of 34 cases) and 97% (33 out of 34 cases), respectively. There was no postoperative mortality. In 2 patients, mild postoperative permanent morbidity (5.9%), presumably related to this technique, was observed in the early cases in the current group (34 case series).
The method was estimated as safe and feasible for diagnostic tissue sampling of intraparenchymal brain lesions.
作者报告了一系列通过经皮质途径进行导航引导下硬质内镜活检以评估脑实质内病变的病例,以评估该方法的可行性和有效性。
34例经神经影像学检查发现脑实质内病变的患者接受了导航引导下的硬质内镜活检。术前诊断大多为世界卫生组织II-IV级胶质瘤(16例)或恶性淋巴瘤(15例)。分别有28例和29例采用术中光动力诊断和术中病理诊断。2例病变小且深的病例,术中使用磁共振成像确认活检点的准确性。
术后影像学确定的采样准确率和确诊率分别为94%(34例中的32例)和97%(34例中的33例)。无术后死亡病例。在当前组(34例病例系列)的早期病例中,2例患者出现轻度术后永久性并发症(5.9%),可能与该技术有关。
该方法被认为对于脑实质内病变的诊断性组织采样是安全可行的。