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磁共振成像引导的框架式立体定向脑干活检术:单中心经验

MRI-guided frame-based stereotactic brainstem biopsy procedure: A single-center experience.

作者信息

Akay Ali, Işlekel Sertaç

机构信息

Department of Neurosurgery, Kent Hospital, İzmir, Turkey.

Department of Neurosurgery, Kent Hospital, İzmir, Turkey.

出版信息

Neurocirugia (Astur : Engl Ed). 2019 Jul-Aug;30(4):167-172. doi: 10.1016/j.neucir.2019.03.001. Epub 2019 Apr 15.

Abstract

INTRODUCTION AND OBJECTIVES

This study aims at presenting our experience of the MRI-guided frame-based stereotactic brainstem biopsy method, and evaluating the outcomes of the procedure.

PATIENTS AND METHODS

The current study involved 18 cases that underwent MRI-guided frame-based stereotactic biopsy for brainstem lesions between 2011 and 2018 in our clinic. The relevant data regarding the technique of the biopsy procedure, morbidity, histopathological diagnosis it yields and diagnostic accuracy was retrospectively analyzed.

RESULTS

Stereotactic biopsy procedure was performed on 18 patients, including 16 adults and two children. MRI was used as guidance for the biopsy procedure in all patients. The adult patients had the biopsy under local anesthesia; as for the pediatric patients local anesthesia plus sedation was used. All patients received diagnosis based on the histopathological examination of their biopsy samples. No equivocal or negative results, and no major morbidity or mortality was seen in the patients after the procedure.

CONCLUSIONS

MRI-guided frame-based stereotactic biopsy can be considered as a safe and efficient diagnostic method for brainstem lesions when its diagnostic yield and its morbidity and/or mortality rates are evaluated. Choosing the best trajectory for each lesion, using MRI as guidance for targeting, taking a limited number of biopsy samples are valuable criteria for the decreased morbidity rates in stereotactic brainstem biopsy procedures.

摘要

引言与目的

本研究旨在介绍我们在MRI引导下基于框架的立体定向脑干活检方法方面的经验,并评估该手术的结果。

患者与方法

本研究纳入了2011年至2018年期间在我院接受MRI引导下基于框架的立体定向脑干病变活检的18例患者。对活检手术技术、发病率、所获得的组织病理学诊断及诊断准确性的相关数据进行了回顾性分析。

结果

对18例患者进行了立体定向活检,其中包括16例成人和2例儿童。所有患者的活检手术均以MRI为引导。成年患者在局部麻醉下进行活检;儿科患者则采用局部麻醉加镇静。所有患者均根据活检样本的组织病理学检查获得诊断。术后患者未出现模棱两可或阴性结果,也未出现严重的发病率或死亡率。

结论

当评估MRI引导下基于框架的立体定向活检的诊断率及其发病率和/或死亡率时,可将其视为一种安全有效的脑干病变诊断方法。为每个病变选择最佳路径、以MRI为靶向引导、采集有限数量的活检样本是降低立体定向脑干活检手术发病率的重要标准。

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