Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Can Assoc Radiol J. 2019 Feb;70(1):96-103. doi: 10.1016/j.carj.2018.09.003.
In suspected spondylodiscitis and vertebral osteomyelitis, computed tomography (CT)-guided biopsies are often performed to determine a causative organism and guide antimicrobial therapy. The aim of this study is to determine the diagnostic culture yield of CT-guided biopsies performed in cases of suspected spinal infections.
A literature search of PubMed and MEDLINE up to April 2017 was performed for keywords "CT guided vertebral biopsy infection," "CT-guided spine biopsy infection," "CT guided spine biopsy yield," and "CT guided vertebral biopsy yield." Inclusion criteria primarily consisted of studies exclusively using CT-guided biopsies in cases of suspected infectious lesions only. After study selection, published articles were analysed to determine diagnostic culture yield. Descriptive statistics were applied.
220 search results were screened; 11 met our inclusion criteria and were reviewed. In total, 647 biopsies of suspected infectious spinal lesions were performed. Positive cultures were obtained in 241 cases. Upon excluding one paper's skewed results, the net pooled results culture yield was 33%. Several cultures grew multiple organisms, leading to a total of 244 species identified. Most common isolated organisms include Staphylococcus aureus (n = 83), coagulase-negative Staphylococcus (n = 45), and Mycobacteria (n = 38).
The diagnostic culture yield of CT-guided biopsies in cases of suspected spinal infection is 33%. In the majority of cases, a causative organism is not identified. This suggests that improvements can be made in biopsy technique and specimen transfer to optimize culture yield and increase the clinical value of the procedure.
在疑似脊椎椎间盘炎和脊椎骨髓炎的情况下，通常进行计算机断层扫描（CT）引导下活检，以确定病原体并指导抗菌治疗。本研究旨在确定疑似脊柱感染患者行 CT 引导下活检的诊断培养阳性率。
对 PubMed 和 MEDLINE 进行了截至 2017 年 4 月的文献检索，使用的关键词包括“CT 引导下脊椎活检感染”、“CT 引导下脊柱活检感染”、“CT 引导下脊柱活检阳性率”和“CT 引导下脊椎活检阳性率”。纳入标准主要包括仅使用 CT 引导下活检来诊断疑似感染性病变的研究。在进行研究选择后，分析发表的文章以确定诊断培养阳性率。应用描述性统计学方法。
共筛选出 220 项检索结果，其中 11 项符合纳入标准并进行了综述。共对 647 例疑似感染性脊柱病变进行了活检。241 例获得阳性培养结果。排除一篇文章的偏倚结果后，净汇总结果的培养阳性率为 33%。有几种培养物可培养出多种病原体，共鉴定出 244 种病原体。最常见的分离病原体包括金黄色葡萄球菌（n=83）、凝固酶阴性葡萄球菌（n=45）和分枝杆菌（n=38）。
疑似脊柱感染患者行 CT 引导下活检的诊断培养阳性率为 33%。在大多数情况下，无法确定病原体。这表明可以改进活检技术和标本转移，以优化培养阳性率，提高该操作的临床价值。
