James M D, Bova F J, Rajon D A, Carrera-Justiz S, Clemmons R M
Small Animal Clinical Sciences, University of Florida, Gainesville, Florida 32610-0116, USA.
Neurosurgery Department, University of Florida, Gainesville, Florida 32610-0265, USA.
J Small Anim Pract. 2017 Nov;58(11):615-621. doi: 10.1111/jsap.12705. Epub 2017 Aug 26.
The objective of this pilot study was to describe the application and first preliminary data of a novel MRI and CT compatible patient-specific facemask for stereotactic brain biopsy of intracranial lesions in dogs.
Five client-owned dogs presenting for neurological deficits consistent with forebrain disease were included in the study. All dogs had MRI findings consistent with an intracranial lesion. Using images obtained from either MRI or CT, a virtual three-dimensional model of each dog's face was generated. The contact surface of each dog's face was selected for facemask design and a target point for biopsy was chosen using specialised software and toolkits. A patient-specific facemask with an attached biopsy port with premeasured and preselected trajectory was then fabricated by a 3D printer. The facemasks were sterilised and used intraoperatively to obtain biopsy samples. Biopsy samples were submitted for both cytological and histopathological evaluation.
The diagnostic yield based on specific histological diagnosis was 80%. The one case in which a histological diagnosis could not be confirmed had a cytological interpretation consistent with meningioma. No major complications were observed during or immediately after brain biopsy and all dogs were discharged from the hospital within 72 hours postprocedure.
In conclusion, patient-specific facemasks appear to be a safe and effective method of brain biopsy in dogs, with minimal complications observed.
本初步研究的目的是描述一种新型的与MRI和CT兼容的、针对犬颅内病变立体定向脑活检的个性化面罩的应用及首批初步数据。
研究纳入了5只因出现与前脑疾病相符的神经功能缺损而就诊的客户-owned犬。所有犬的MRI检查结果均与颅内病变相符。利用从MRI或CT获取的图像，生成每只犬面部的虚拟三维模型。选择每只犬面部的接触面进行面罩设计，并使用专门的软件和工具包选择活检靶点。然后通过3D打印机制作带有预测量和预选轨迹的附活检端口的个性化面罩。对面罩进行消毒并在手术中用于获取活检样本。将活检样本送去进行细胞学和组织病理学评估。
基于特定组织学诊断的诊断率为80%。1例无法确诊组织学诊断的病例，其细胞学解释与脑膜瘤一致。在脑活检期间或之后即刻未观察到重大并发症，所有犬在术后72小时内出院。
总之，个性化面罩似乎是犬脑活检的一种安全有效的方法，观察到的并发症极少。
