Cohen Micah G, McMahon Colm J, Kung Justin W, Wu Jim S
1 All authors: Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215.
AJR Am J Roentgenol. 2016 May;206(5):W83-6. doi: 10.2214/AJR.15.15067. Epub 2016 Mar 9.
The purpose of this study was to compare manual and battery-powered bone biopsy systems for diagnostic yield and procedural factors during core needle biopsy of sclerotic bone lesions.
A total of 155 consecutive CT-guided core needle biopsies of sclerotic bone lesions were performed at one institution from January 2006 to November 2014. Before March 2012, lesions were biopsied with manual bone drill systems. After March 2012, most biopsies were performed with a battery-powered system and either noncoaxial or coaxial biopsy needles. Diagnostic yield, crush artifact, CT procedure time, procedure radiation dose, conscious sedation dose, and complications were compared between the manual and battery-powered core needle biopsy systems by Fisher exact test and t test. One-way ANOVA was used for subgroup analysis of the two battery-powered systems for procedure time and radiation dose.
The diagnostic yield for all sclerotic lesions was 60.0% (93/155) and was significantly higher with the battery-powered system (73.0% [27/37]) than with the manual systems (55.9% [66/118]) (p = 0.047). There was no significant difference between the two systems in terms of crush artifact, procedure time, radiation dose, conscious sedation administered, or complications. In subgroup analysis, the coaxial battery-powered biopsies had shorter procedure times (p = 0.01) and lower radiation doses (p = 0.002) than the coaxial manual systems, but the noncoaxial battery-powered biopsies had longer average procedure times and higher radiation doses than the coaxial manual systems.
In biopsy of sclerotic bone lesions, use of a battery-powered bone drill system improves diagnostic yield over use of a manual system.
本研究旨在比较手动和电动骨活检系统在硬化性骨病变粗针活检过程中的诊断率和操作因素。
2006年1月至2014年11月期间,在一家机构对155例连续的硬化性骨病变进行了CT引导下的粗针活检。2012年3月之前,使用手动骨钻系统进行病变活检。2012年3月之后,大多数活检使用电动系统和非同轴或同轴活检针。通过Fisher精确检验和t检验比较手动和电动粗针活检系统之间的诊断率、挤压伪像、CT操作时间、操作辐射剂量、清醒镇静剂量和并发症。采用单因素方差分析对两种电动系统的操作时间和辐射剂量进行亚组分析。
所有硬化性病变的诊断率为60.0%(93/155),电动系统的诊断率(73.0%[27/37])显著高于手动系统(55.9%[66/118])(p = 0.047)。两种系统在挤压伪像、操作时间、辐射剂量、给予的清醒镇静或并发症方面无显著差异。在亚组分析中,同轴电动活检的操作时间比同轴手动系统短(p = 0.01),辐射剂量低(p = 0.002),但非同轴电动活检的平均操作时间比同轴手动系统长,辐射剂量高。
在硬化性骨病变活检中,使用电动骨钻系统比手动系统能提高诊断率。