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大型队列中脑病变立体定向穿刺活检出血的危险因素:单中心10年经验

The risk factors of hemorrhage in stereotactic needle biopsy for brain lesions in a large cohort: 10 years of experience in a single center.

作者信息

Li Hailong, Zheng Chunling, Rao Wei, Sun Junzhao, Yu Xin, Zhang Jianning

机构信息

Neurosurgery Medical Department, PLA General Hospital, No. 28, Fuxing Road, Haidian District, 100853, Beijing, China.

Cardiovascular Medical Department, PLA General Hospital, No. 6, Fucheng Road, Haidian District, 100048, Beijing, China.

出版信息

Chin Neurosurg J. 2022 Dec 9;8(1):40. doi: 10.1186/s41016-022-00307-y.

Abstract

BACKGROUND

This study aimed to identify the risk factors for hemorrhage from a large cohort who underwent stereotactic needle biopsy for brain lesions at a single center over a 10-year period.

METHODS

We performed a retrospective chart review of consecutive patients who underwent stereotactic biopsy at our institute between January 2010 and December 2019. Demographic characteristics and clinical variables were collected and analyzed to identify risk factors for postbiopsy hemorrhage using the chi-square test and univariable and multivariable logistic regression analyses.

RESULTS

A total of 3196 patients were included in this study; of these, a histological diagnosis was eventually made for 2938 (91.93%) patients. Hemorrhage occurred in 149 (4.66%) patients, and symptomatic hemorrhage occurred in 46 (1.44%) patients. In multivariable logistic regression analyses, the presence of deep-seated lesions (OR 1.272, p = 0.035), concomitant edema and enhancement on MR imaging scans (OR 1.827, p = 0.002), intraoperative hypertension without a past history (OR 1.012, p = 0.024), and the presence of high-grade glioma (OR 0.306, p = 0.003) were identified as independent predictors of hemorrhage after biopsy.

CONCLUSION

Stereotactic needle biopsy is a safe and effective way to obtain tissue from brain lesions for histological diagnosis. The presence of deep-seated lesions, concomitant edema, and enhancement on MR imaging scans and the presence of high-grade glioma are independent predictors of hemorrhage after stereotactic biopsy.

摘要

背景

本研究旨在确定在一个单一中心接受为期10年的脑病变立体定向穿刺活检的大型队列中出血的危险因素。

方法

我们对2010年1月至2019年12月在我院接受立体定向活检的连续患者进行了回顾性病历审查。收集并分析人口统计学特征和临床变量,使用卡方检验、单变量和多变量逻辑回归分析来确定活检后出血的危险因素。

结果

本研究共纳入3196例患者;其中,最终对2938例(91.93%)患者做出了组织学诊断。149例(4.66%)患者发生出血,46例(1.44%)患者发生症状性出血。在多变量逻辑回归分析中,深部病变的存在(OR 1.272,p = 0.035)、磁共振成像扫描上伴有水肿和强化(OR 1.827,p = 0.002)、无既往病史的术中高血压(OR 1.012,p = 0.024)以及高级别胶质瘤的存在(OR 0.306,p = 0.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c842/9732999/7f9cc27b1c2a/41016_2022_307_Fig1_HTML.jpg

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