Radiology Department, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, United Kingdom.
University College London Hospital, 235 Euston Rd, London, NW1 2BU, United Kingdom.
Eur J Radiol. 2021 Feb;135:109469. doi: 10.1016/j.ejrad.2020.109469. Epub 2020 Dec 5.
To determine the efficacy of image-guided core needle biopsy (IGCNB) in patients presenting with suspected intra-articular soft tissue tumours or tumour-like lesions.
Retrospective study of patients referred to a musculoskeletal oncology service between January 2019 and May 2020 with a suspected intra-articular soft tissue tumour over a 16-month period. Data collected included patient age, gender, joint involved and maximal lesion size. Type of image-guidance (ultrasound or computed tomography), type of needle and type of anaesthesia, general anaesthetic (GA) or local anaesthetic (LA), were recorded, as was the histological diagnosis. For patients who proceeded to surgical excision, the IGCNB histology result was correlated with resection histology. Descriptive statistics were used and complications were also noted.
By the termination of data collection 91 patients underwent IGCNB, 32 (35.2 %) males and 59 (64.8 %) females with a mean age of 41.4 years (age range 3-86 years). The joints involved were the knee (n = 73; 80.2 %), ankle (n = 12; 13.2 %), hip (n = 3; 3.3 %), shoulder (n = 1; 1.1 %), elbow (n = 1; 1.1 %) and wrist (n = 1; 1.1 %). Biopsy types were as follows: US-guided GA (n = 29; 31.9 %), US-guided LA (n = 37; 40.7 %), CT-guided GA, (n = 23; 25.3 %), CT-guided LA (n = 2; 2.2 %). Mean maximal tumour dimension for 76 focal lesions was 36.5 mm (range 18-113 mm). IGCNB yielded a definitive histological result in 85 of 91 cases (93.4 %), 44 of whom went on to surgical resection. Concordance between IGCNB and resection histology was achieved in 42 of 44 cases (95.5 %). The commonest diagnosis was tenosynovial giant cell tumour, with only a single malignant lesion identified. There were no recorded immediate or delayed complications.
IGCNB of suspected intra-articular tumours or tumour-like lesions is a highly effective and safe technique.
确定在疑似关节内软组织肿瘤或肿瘤样病变患者中使用影像引导下核心针活检（IGCNB）的疗效。
对 2019 年 1 月至 2020 年 5 月期间在肌肉骨骼肿瘤专科就诊的疑似关节内软组织肿瘤患者进行回顾性研究，研究期间共 16 个月。收集的数据包括患者年龄、性别、受累关节和最大病变大小。记录了影像引导方式（超声或计算机断层扫描）、针的类型和麻醉类型（全身麻醉或局部麻醉），以及组织学诊断。对于接受手术切除的患者，将 IGCNB 组织学结果与切除组织学结果进行了相关性分析。采用描述性统计方法，并记录了并发症。
在数据收集结束时，91 名患者接受了 IGCNB，其中 32 名（35.2%）为男性，59 名（64.8%）为女性，平均年龄为 41.4 岁（年龄范围 3-86 岁）。受累关节为膝关节（n=73；80.2%）、踝关节（n=12；13.2%）、髋关节（n=3；3.3%）、肩关节（n=1；1.1%）、肘关节（n=1；1.1%）和腕关节（n=1；1.1%）。活检类型如下：超声引导下全身麻醉（n=29；31.9%）、超声引导下局部麻醉（n=37；40.7%）、CT 引导下全身麻醉（n=23；25.3%）、CT 引导下局部麻醉（n=2；2.2%）。76 个局灶性病变的最大肿瘤尺寸平均值为 36.5mm（范围 18-113mm）。91 例患者中有 85 例（93.4%）获得了明确的组织学结果，其中 44 例患者进行了手术切除。IGCNB 与切除组织学的一致性在 44 例中有 42 例（95.5%）得到了证实。最常见的诊断是腱鞘巨细胞瘤，仅发现 1 例恶性病变。无记录到即时或延迟并发症。
在疑似关节内肿瘤或肿瘤样病变患者中，IGCNB 是一种非常有效和安全的技术。
