Vancouver General Hospital/ University of British Columbia, Vancouver, Canada.
Vancouver General Hospital/ University of British Columbia, Vancouver, Canada.
Tech Vasc Interv Radiol. 2022 Mar;25(1):100800. doi: 10.1016/j.tvir.2022.100800. Epub 2022 Jan 16.
Image guided percutaneous biopsy has become the initial procedure of choice in most cases for obtaining bone samples for histological and microbiological assessment. It is a minimally invasive procedure which offers multiple advantages over open surgical biopsy including maintenance of bone structure, minimal soft tissue injury, reduced need of general anesthesia, reduced hospital stay and a low rate of post-procedure complications. In some cases, it can be combined with therapeutic procedures such as cementoplasty and cryoablation via the same access route. For the radiologist, knowledge of the key principles is essential for a safe and effective procedure, particularly when a sarcoma of bone is in the differential diagnosis. In this article we cover the core concepts of percutaneous bone biopsy including indications and contraindications, essential planning steps, appropriate imaging modalities, equipment selection, common approaches, technique as well as avoiding, recognizing and treating complications. Recent technological advancements in this field are also discussed.
在大多数情况下，影像引导经皮穿刺活检已成为获取骨骼样本进行组织学和微生物评估的首选初始操作。该操作具有微创优势，与开放式外科活检相比，其具有维持骨骼结构、最小化软组织损伤、减少全身麻醉需求、缩短住院时间和降低术后并发症发生率等优点。在某些情况下，它可以与同种入路途径的治疗性操作（如骨水泥成形术和冷冻消融术）联合进行。对于放射科医生而言，了解关键原则对于安全有效的操作至关重要，特别是在鉴别诊断为骨肉瘤时。本文涵盖了经皮骨活检的核心概念，包括适应证和禁忌证、基本规划步骤、合适的影像学方法、设备选择、常见入路、技术以及并发症的避免、识别和处理。此外，还讨论了该领域的最新技术进展。
