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经皮CT引导下脊柱活检的准确性及活检成功的决定因素

Accuracy of Percutaneous CT-Guided Spine Biopsy and Determinants of Biopsy Success.

作者信息

Gul Selim Baris, Polat Ahmet Veysel, Bekci Tumay, Selcuk Mustafa Bekir

机构信息

Aksaray State Hospital, TR.

Ondokuz Mayis University Faculty of Medicine, TR.

出版信息

J Belg Soc Radiol. 2016 May 31;100(1):62. doi: 10.5334/jbr-btr.985.

Abstract

PURPOSE

The purpose of this study was to investigate the accuracy of CT-guided spine biopsy as well as the factors that may influence its success.

METHODS AND MATERIALS

A total of 170 CT-guided biopsies performed on 156 patients with vertebral lesions were retrospectively analyzed. The accuracy of the biopsies was evaluated by comparing the final diagnosis with the biopsy results for patients who underwent surgery or with six-month clinical and radiological follow-up findings for patients who did not have surgery. The radiological features of each lesion, the features of the needles used, the needle approach, the pathology results, and the patient demographic data were statistically analyzed with Fisher exact test and ANOVA for their influence on the success of the biopsy.

RESULTS

The total success rate of percutaneous vertebral needle biopsies performed with CT guidance was 80 per cent (136/170). Age ( = 0.39), gender ( = 0.43), lesion location ( = 0.2), radiographic appearance ( = 0.8), needle type ( = 0.6), and approach ( = 0.1) had no effect on the adequacy of the obtained material or the success of the biopsy. There was a relationship between lesion histopathology and the rate of adequacy or success ( < 0.001). There was no relationship between the needle approach or the radiographic appearance of the lesion and the length of the specimen ( = 0.1). There were no major complications requiring treatment.

CONCLUSION

The success rate of CT-guided percutaneous needle biopsy was close to that found in previous studies in the literature and independent of most patient parameters. Its complication rates are acceptable in experienced hands.

摘要

目的

本研究旨在调查CT引导下脊柱活检的准确性以及可能影响其成功率的因素。

方法与材料

对156例椎体病变患者进行的170例CT引导下活检进行回顾性分析。通过将最终诊断与接受手术患者的活检结果或未接受手术患者的六个月临床和影像学随访结果进行比较,评估活检的准确性。使用Fisher精确检验和方差分析对每个病变的放射学特征、所用针的特征、进针途径、病理结果和患者人口统计学数据对活检成功率的影响进行统计分析。

结果

CT引导下经皮椎体穿刺活检的总成功率为80%(136/170)。年龄(P = 0.39)、性别(P = 0.43)、病变位置(P = 0.2)、影像学表现(P = 0.8)、针型(P = 0.6)和进针途径(P = 0.1)对所获材料的充分性或活检的成功率没有影响。病变组织病理学与充分率或成功率之间存在关联(P < 0.001)。进针途径或病变的影像学表现与标本长度之间没有关联(P = 0.1)。没有需要治疗的严重并发症。

结论

CT引导下经皮穿刺活检的成功率与文献中先前研究的结果相近,且与大多数患者参数无关。在经验丰富的操作者手中,其并发症发生率是可以接受的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc5/5854449/2587b6a58da7/jbsr-100-1-985-g1.jpg

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