Department of Diagnostic Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020, PO Box 11-0236, Beirut, Lebanon.
Skeletal Radiol. 2022 Nov;51(11):2155-2166. doi: 10.1007/s00256-022-04078-6. Epub 2022 May 25.
Bone marrow biopsy complications are rare. Our aim is to study the association of improper palpation-guided iliac biopsy tract with complications.
This is a retrospective study of adult patients who underwent iliac bone marrow biopsy without image guidance at our hospital from January 2019 to January 2021, and have cross-sectional radiologic imaging of the pelvis within 30 days following the procedure. Electronic health records were reviewed for clinical data. Two radiologists reviewed images of the pelvis for assessment of biopsy tract and complications.
A total of 443 procedures were included in 309 patients, mean age 53.4 ± 18.1 years, 112 females (36.2%). In addition, 332 tracts were proper (75%), 97 improper (22%), and 14 unidentified (3%). All 11 complications occurred in procedures with improper tracts; nine bleeding, one fracture, and one facet joint injury. Improper tract was significantly associated with complications (p < .001). There was no statistically significant association between platelet count, international normalized ratio, antiplatelet use and anticoagulant use, and presence of complications (p > .05). Body mass index and subcutaneous fat thickness overlying posterior superior iliac spine were not associated with improper tract (p > .05). Procedures performed by providers with ≤ 12 months' experience were significantly associated with improper tract (p < .001) and hence associated with complications (p = .007).
Improper tracts were common in palpation-guided iliac bone marrow biopsy and significantly associated with complications. No complications were encountered in proper tract procedures. Procedures performed by providers with ≤ 12 months' experience were significantly associated with improper tract and complications.
骨髓活检并发症罕见。我们的目的是研究不当触诊引导的髂骨活检通道与并发症之间的关系。
这是一项回顾性研究，纳入了 2019 年 1 月至 2021 年 1 月期间在我院行无影像引导髂骨骨髓活检的成年患者，术后 30 天内行骨盆横断面影像学检查。电子病历记录了临床数据。两名放射科医生评估了骨盆图像以评估活检通道和并发症。
共纳入 309 例患者的 443 例次操作，平均年龄为 53.4±18.1 岁，女性 112 例（36.2%）。此外，332 条通道为规范（75%），97 条不规范（22%），14 条未识别（3%）。所有 11 例并发症均发生在不规范通道的操作中；9 例为出血，1 例为骨折，1 例为小关节损伤。不规范的通道与并发症显著相关（p<0.001）。血小板计数、国际标准化比值、抗血小板药物和抗凝药物的使用与并发症的发生无统计学显著相关性（p>0.05）。身体质量指数和髂后上棘上方的皮下脂肪厚度与不规范的通道无相关性（p>0.05）。经验少于 12 个月的医生操作的程序与不规范的通道显著相关（p<0.001），因此与并发症显著相关（p=0.007）。
触诊引导的髂骨骨髓活检中不规范的通道很常见，与并发症显著相关。规范通道的操作中没有并发症。经验少于 12 个月的医生操作的程序与不规范的通道和并发症显著相关。
