Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York, USA.
Department of Neurosurgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York, USA.
World Neurosurg. 2021 Mar;147:144-149. doi: 10.1016/j.wneu.2020.11.128. Epub 2020 Dec 9.
Biopsy of pineal region neoplasms is frequently accomplished by way of endoscopic transventricular access or using an image-guided, computer-assisted stereotactic approach.
We evaluated a nonorthogonal lateral temporal approach for stereotactic biopsy of pineal region tumors as a variation of previously described stereotactic methods. Magnetic resonance imaging-guided frameless stereotaxy was used to plan and perform biopsies of pineal region tumors using a nonorthogonal trajectory extending from the superior or middle temporal gyri through the temporal stem, anterior to the atrium of the lateral ventricle, and posterior to the corticospinal tract.
All patients had an uncomplicated postoperative course and remained at neurologic baseline. No parenchymal or ventricular hemorrhage was present on postoperative scans. A tissue diagnosis was obtained in all patients.
This method appears to be a safe alternative to stereotactic biopsy using other trajectories and provides adequate tissue for definitive diagnosis.
通过经脑室内镜进入或使用图像引导、计算机辅助立体定向方法，常可对松果体区域肿瘤进行活检。
我们评估了一种非正交侧颞部入路，作为以前描述的立体定向方法的一种变化，用于对松果体区域肿瘤进行立体定向活检。使用磁共振成像引导无框架立体定向术，通过从颞上或中回延伸的非正交轨迹，经颞干、侧脑室前房前方、皮质脊髓束后方，对松果体区域肿瘤进行活检。
所有患者术后均恢复顺利，神经功能保持基线水平。术后扫描未见实质或脑室出血。所有患者均获得组织学诊断。
与使用其他轨迹的立体定向活检相比，这种方法似乎是一种安全的替代方法，可提供足够的组织进行明确诊断。
