Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah.
Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Oregon.
Semin Musculoskelet Radiol. 2021 Dec;25(6):711-724. doi: 10.1055/s-0041-1735471. Epub 2021 Dec 22.
Imaging-guided needle biopsy of musculoskeletal lesions is a high-yield and low-risk procedure that can be used for definitive characterization of indeterminate bone and soft tissue lesions. Familiarity with the preprocedural, technical, and postprocedural steps is vital for the appropriate management of these cases. Biopsy request triage requires an awareness of definitively benign conditions and other tumor mimics. A complete clinical, laboratory, and imaging work-up is essential for procedural planning and determining pathologic concordance. Consultation with an orthopaedic oncologist is a requisite step to ensure maximizing biopsy yield and to avoid interference with any future limb-sparing surgical intervention. Knowledge of the equipment, pertinent medications, and appropriate biopsy technique can minimize the risk of periprocedural complications. Finally, the radiologist may be required to discuss the concordance of histopathology with preprocedure imaging, perform repeat image-guided biopsy, and carefully interpret sarcoma surveillance imaging examinations.
影像学引导下的肌肉骨骼病变活检是一种高收益、低风险的操作，可以明确诊断不确定的骨和软组织病变。熟悉术前、技术和术后步骤对于这些病例的恰当处理至关重要。活检申请的分诊需要了解明确的良性疾病和其他肿瘤模拟物。完整的临床、实验室和影像学检查对于手术计划和确定病理一致性至关重要。与骨肿瘤科医生的会诊是确保最大程度提高活检收益和避免任何未来保肢手术干预的必要步骤。了解设备、相关药物和适当的活检技术可以最大程度地降低围手术期并发症的风险。最后，放射科医生可能需要讨论组织病理学与术前影像学的一致性，进行重复的影像引导活检，并仔细解读肉瘤监测影像学检查。
