Chehab Monzer, Zintsmaster Stephen, Jafri Syed Zafar, Richards Mark, Roy Anindya
Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USA.
Cleveland Clinic Regional Radiology, Akron General Hospital, 1 Akron General Ave, Akron, OH, 44307, USA.
Cardiovasc Intervent Radiol. 2017 Sep;40(9):1461-1468. doi: 10.1007/s00270-017-1669-2. Epub 2017 May 4.
To describe the techniques, outcomes and complications of CT-guided transosseous biopsy of soft tissue lesions via multiple different routes.
Clinical and radiologic data from all consecutive soft tissue biopsies performed via a transosseous approach between April 2009 and July 2015 were retrospectively compiled. Fifty biopsies performed in 50 patients (n = 17 males, n = 33 females) were included. Biopsies were performed using a 13-gauge biopsy needle which was advanced through the selected bone to the lesion margin followed by coaxial placement of either an 18- or 20-gauge biopsy gun. Sampling accuracy was determined from the final pathology report as diagnostic or non-diagnostic. Complications included rates of pneumothorax, pneumomediastinum, hemoptysis, immediate admission, chest tube insertion, surgical consultation, 30-day readmission, fracture, osteomyelitis or tract seeding.
Number of diagnostic samples per bone included: sternum (n = 17, 34%), rib (n = 7, 14%), scapula (n = 6, 12%), transverse process (n = 4, 8%), vertebral body (n = 4, 8%), spinous process (n = 1, 2%), ilium (n = 7, 14%), sacrum (n = 4, 8%). Complications included 10 pneumothoraces in 39 cases that crossed the pleura, 8 pneumomediastinum in 17 transsternal cases, one immediate surgical consultation and one 30-day readmission.
Transosseous biopsy approach is a technically feasible means of obtaining core needle samples of soft tissue lesions.
Case series, IV.
描述经多种不同路径的CT引导下软组织病变经骨活检的技术、结果及并发症。
回顾性收集2009年4月至2015年7月间所有经骨途径进行的连续性软组织活检的临床及放射学资料。纳入50例患者（男17例，女33例）的50次活检。活检采用13号活检针，穿过选定的骨骼推进至病变边缘，随后同轴放置18号或20号活检枪。根据最终病理报告确定取样准确性为诊断性或非诊断性。并发症包括气胸、纵隔积气、咯血、立即住院、置胸管、外科会诊、30天再入院、骨折、骨髓炎或针道种植的发生率。
每块骨的诊断性样本数量包括：胸骨（17例，34%）、肋骨（7例，14%）、肩胛骨（6例，12%）、横突（4例，8%）、椎体（4例，8%）、棘突（1例，2%）、髂骨（7例，14%）、骶骨（4例，8%）。并发症包括39例穿过胸膜的病例中有10例气胸，17例经胸骨活检病例中有8例纵隔积气，1例立即进行外科会诊和1例30天再入院。
经骨活检方法是获取软组织病变粗针样本的一种技术上可行的手段。
病例系列，IV级。
