Department of Rheumatology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Department of Medicine, The University of Melbourne at St Vincent's Hospital, Fitzroy, Victoria, Australia.
Neuropathol Appl Neurobiol. 2023 Feb;49(1):e12888. doi: 10.1111/nan.12888.
Muscle biopsy techniques range from needle muscle biopsy (NMB) and conchotome biopsy to open surgical biopsy. It is unknown whether specific biopsy techniques offer superior diagnostic yield or differ in procedural complication rates. Therefore, we aimed to compare the diagnostic utility of NMB, conchotome and open muscle biopsies in the assessment of neuromuscular disorders.
A systematic literature review of the EMBASE and Medline (Ovid) databases was performed to identify original, full-length research articles that described the muscle biopsy technique used to diagnose neuromuscular disease in both adult and paediatric patient populations. Studies of any design, excluding case reports, were eligible for inclusion. Data pertaining to biopsy technique, biopsy yield and procedural complications were extracted.
Sixty-four studies reporting the yield of a specific muscle biopsy technique and, or procedural complications were identified. Open surgical biopsies provided a larger tissue sample than any type of percutaneous muscle biopsy. Where anaesthetic details were reported, general anaesthesia was required in 60% of studies that reported open surgical biopsies. Percutaneous biopsies were most commonly performed under local anaesthesia and despite the smaller tissue yield, moderate- to large-gauge needle and conchotome muscle biopsies had an equivalent diagnostic utility to that of open surgical muscle biopsy. All types of muscle biopsy procedures were well tolerated with few adverse events and no scarring complications were reported with percutaneous sampling.
When a histological diagnosis of myopathy is required, moderate- to large-gauge NMB and the conchotome technique appear to have an equivalent diagnostic yield to that of an open surgical biopsy.
肌肉活检技术包括针吸肌肉活检（NMB）、环钻活检和开放式外科活检。目前尚不清楚特定的活检技术是否能提供更高的诊断收益，或者在手术并发症发生率方面是否存在差异。因此，我们旨在比较 NMB、环钻和开放式肌肉活检在评估神经肌肉疾病方面的诊断效用。
对 EMBASE 和 Medline（Ovid）数据库进行系统的文献回顾，以确定描述用于诊断成人和儿科患者神经肌肉疾病的肌肉活检技术的原始、全文研究文章。任何设计的研究，不包括病例报告，都有资格入选。提取与活检技术、活检产量和手术并发症相关的数据。
共确定了 64 项研究报告了特定肌肉活检技术的产量和/或手术并发症。开放式外科活检提供的组织样本比任何类型的经皮肌肉活检都要大。在报告麻醉细节的研究中，有 60%的开放式外科活检需要全身麻醉。经皮活检最常在局部麻醉下进行，尽管组织产量较小，但中等至大口径的针吸和环钻肌肉活检与开放式外科肌肉活检具有同等的诊断效果。所有类型的肌肉活检程序都耐受良好，不良事件很少，经皮取样无疤痕并发症报告。
当需要进行肌病的组织学诊断时，中等至大口径的 NMB 和环钻技术似乎与开放式外科活检具有相同的诊断收益。
