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机器人引导立体定向技术在颅内病变活检诊断中的新应用。

Novel application of robot-guided stereotactic technique on biopsy diagnosis of intracranial lesions.

作者信息

Feng Yan, Yaming Wang, Yongzhi Shan, Penghu Wei, Hong Wang, Xiaotong Fan, Changming Wang, Sichang Chen, Guoguang Zhao

机构信息

Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.

China International Neuroscience Institute (China-INI), Beijing, China.

出版信息

Front Neurol. 2023 Jul 27;14:1173776. doi: 10.3389/fneur.2023.1173776. eCollection 2023.

Abstract

INTRODUCTION

This study was performed to examine whether there is a link between the application of three types of robot-guided stereotactic biopsy techniques and the diagnostic rate of intracranial lesion biopsy.

METHODS

The study involved 407 patients who underwent robot-guided stereotactic intracranial lesion biopsy at Xuanwu Hospital of Capital Medical University from January 2019 to December 2021. Age, sex, lesion characteristics, lesion distribution, surgical method, and target path depth were assessed for their impact on the biopsy diagnostic rate.

RESULTS

The patients' mean age was 42.1 years (range, 6 months-82 years). All patients underwent robot-assisted stereotactic brain biopsy using one of three different systems: a ROSA robotic system (=35), the CAS-R-2 (=65), or the REMEBOT domestic robotic system (=307). No significant difference was found in the diagnostic rate of positive histopathological findings or the mean time of surgery among the three biopsy modalities. The diagnostic rate was 93.86%. Multiple linear regression analysis showed that age, sex, and biopsy modality did not affect the diagnostic rate >0.05), whereas enhancing lesions and smaller-volume lesions (≤l cm3) were significantly correlated with the diagnostic rate ( = 0.01). Lesions located in the suprasellar and pineal regions were significantly associated with the negative diagnostic rate (<0.05).

CONCLUSION

The presence of enhancing lesions, lesion location, and lesion volume significantly affected the diagnostic rate of brain biopsy. Age, sex, lesion depth, and biopsy modality did not significantly affect the diagnostic rate. All three procedures had high safety and effectiveness.

摘要

引言

本研究旨在探讨三种机器人引导立体定向活检技术的应用与颅内病变活检诊断率之间是否存在关联。

方法

该研究纳入了2019年1月至2021年12月在首都医科大学宣武医院接受机器人引导立体定向颅内病变活检的407例患者。评估年龄、性别、病变特征、病变分布、手术方法和靶点路径深度对活检诊断率的影响。

结果

患者的平均年龄为42.1岁(范围为6个月至82岁)。所有患者均使用以下三种不同系统之一进行机器人辅助立体定向脑活检:ROSA机器人系统(=35例)、CAS-R-2(=65例)或瑞迈博国产机器人系统(=307例)。三种活检方式在组织病理学阳性结果的诊断率或平均手术时间方面未发现显著差异。诊断率为93.86%。多元线性回归分析显示,年龄、性别和活检方式对诊断率无影响(>0.05),而强化病变和较小体积病变(≤1 cm³)与诊断率显著相关(=0.01)。位于鞍上和松果体区的病变与阴性诊断率显著相关(<0.05)。

结论

强化病变的存在、病变位置和病变体积显著影响脑活检的诊断率。年龄、性别、病变深度和活检方式对诊断率无显著影响。所有三种手术方法均具有较高的安全性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3db1/10421699/a8e9d8e3a6d0/fneur-14-1173776-g001.jpg

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