Niizuma H, Nakasato N, Jokura H, Otsuki T, Katakura R, Suzuki J
Division of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan.
No Shinkei Geka. 1988 Feb;16(2):141-6.
Biopsy of suspected brain tumor was performed on 104 cases using Leksell's CT-guided stereotaxic system. The entire operation was performed in the CT room. A Backlund's spiral biopsy needle was advanced to the target point in a stepwise fashion and two to nine tissue samples were obtained from one to three biopsy tracks. Tissue sampling was impossible in two cases because the tumors were too hard for biopsy needle to advance. Also, sampling was sometimes difficult in the case of soft and necrotic tumor, cystic tumor, already treated (irradiated) tumor and the lesion including old blood clot. After the biopsy, minimal bleeding occurred in nine cases, however, stopped within 10 minutes by controlling the blood pressure. A minimum sized hematoma was visible on the postoperative CT in four cases. Postoperative neurological deterioration was seen in two cases. One case was transient and the other seemed to be in his natural course. Anyway, there were neither cases of operative mortality nor severely complicated cases in these series. Useful pathological diagnosis was possible in 83 cases (80%). Accurate diagnosis was not possible in the remaining 21 cases, however, their histological datum such as necrosis, blood clot, and so on were very useful to estimate the lesions. In summary, accurate diagnosis rate of CT-guided stereotaxic needle biopsy was 80%. However, it appeared to be a safe and useful procedure in the diagnosis of intracranial mass lesions.
使用Leksell CT引导立体定向系统对104例疑似脑肿瘤患者进行了活检。整个手术在CT室进行。将Backlund螺旋活检针逐步推进至靶点，从一至三条活检路径获取两至九个组织样本。有两例因肿瘤过硬，活检针无法推进，未能进行组织采样。此外，对于质地柔软、坏死的肿瘤、囊性肿瘤、已接受治疗（放疗）的肿瘤以及包含陈旧血凝块的病变，采样有时也很困难。活检后，9例出现轻微出血，但通过控制血压在10分钟内停止。4例术后CT可见最小尺寸的血肿。2例出现术后神经功能恶化。1例为短暂性，另1例似乎是自然病程。无论如何，该系列中既无手术死亡病例，也无严重并发症病例。83例（80%）获得了有用的病理诊断。其余21例无法进行准确诊断，但其组织学数据如坏死、血凝块等对评估病变非常有用。总之，CT引导立体定向针吸活检的准确诊断率为80%。然而，它在颅内占位性病变的诊断中似乎是一种安全且有用的方法。
