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经皮 CT 引导下的头颈部肿块穿刺活检:在单一学术机构中的技术、组织病理学产量和安全性。

Percutaneous CT-Guided Core Needle Biopsies of Head and Neck Masses: Technique, Histopathologic Yield, and Safety at a Single Academic Institution.

机构信息

Mallinckrodt Institute of Radiology (T.J.H., J.C.B., M.V.F, J.W.J.), Musculoskeletal Section, Washington University School of Medicine, St. Louis, Missouri

Musculoskeletal Radiology (J.R.L.), Mayo Clinic Arizona, Phoenix, Arizona.

出版信息

AJNR Am J Neuroradiol. 2020 Nov;41(11):2117-2122. doi: 10.3174/ajnr.A6784. Epub 2020 Sep 17.

Abstract

BACKGROUND AND PURPOSE

CT-guided head and neck biopsies can be challenging due to the anatomy and adjacent critical structures but can often obviate the need for open biopsy. A few studies and review articles have described approaches to biopsy in the head and neck. This retrospective study evaluated technical considerations, histopathologic yield, and safety in CT-guided head and neck core needle biopsies.

MATERIALS AND METHODS

A retrospective review of head and neck biopsies performed from January 2013 through December 2019 was conducted. Clinical diagnosis and indication, patient demographics, mass location and size, biopsy needle type, technical approach, dose-length product, sedation details, complications, diagnostic histopathologic yield, and the use of iodinated contrast were recorded for each case.

RESULTS

A total of 27 CT-guided head and neck core needle biopsies were performed in 26 patients. The diagnostic sample rate was 100% (27/27). A concordant histopathologic diagnosis was obtained in 93% (25/27) of cases. There was a single complication of core needle biopsy, a small asymptomatic superficial hematoma.

CONCLUSIONS

Percutaneous CT-guided biopsy of deep masses in the head and neck is safe and effective with careful biopsy planning and has a high diagnostic yield that can obviate the need for open biopsy.

摘要

背景与目的

由于解剖结构和邻近的关键结构,CT 引导下的头颈部活检具有挑战性,但通常可以避免开颅活检的需要。有一些研究和综述文章描述了头颈部活检的方法。本回顾性研究评估了 CT 引导下头颈部核心针活检的技术考虑因素、组织病理学检出率和安全性。

材料与方法

对 2013 年 1 月至 2019 年 12 月期间进行的头颈部活检进行了回顾性分析。记录了每个病例的临床诊断和适应证、患者人口统计学、肿块位置和大小、活检针类型、技术方法、剂量长度乘积、镇静细节、并发症、诊断组织病理学检出率以及碘造影剂的使用情况。

结果

共对 26 例患者的 27 例 CT 引导下头颈部核心针活检进行了分析。诊断样本检出率为 100%(27/27)。93%(25/27)的病例获得了一致的组织病理学诊断。仅有 1 例出现核心针活检相关并发症,即无症状的小面积浅表血肿。

结论

对头颈部深部肿块进行经皮 CT 引导活检是安全有效的,需要仔细的活检计划,具有较高的诊断检出率,可以避免开颅活检的需要。

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