Betting Theodore, Benson John C, Madhavan Ajay, Shlapak Darya, Morris Padraig, Morris Jonathan, Diehn Felix, Verdoorn Jared, Liebo Greta, Carr Carrie
Mayo Clinic, Rochester, 200 1st St. SW, Rochester, MN, 55905, USA.
Neuroradiology. 2024 Mar;66(3):417-425. doi: 10.1007/s00234-023-03266-y. Epub 2024 Jan 10.
Although CT-guided biopsies of the calvarium, skull base, and orbit are commonly performed, the best approaches, efficacy, and safety of such procedures remain scantly described in the literature. This retrospective review of percutaneous biopsies illustrates several approaches to challenging biopsy targets and provides a review of procedural planning considerations and histopathologic yield.
A retrospective review of CT-guided biopsies of the skull base, calvarium, and orbit between 1/1/2010 and 10/30/2020 was conducted. Patient demographics and procedural factors were recorded, including lesion size and location, biopsy approach, and needle gauge. Outcomes were also noted, including CT dose length product, complications, and histopathologic yield.
Sixty-one CT-guided biopsies were included in the final analysis: 34 skull base, 23 calvarial, and 4 orbital lesions. The initial diagnostic yield was 32/34 (94%) for skull base lesions, with one false-negative and one non-diagnostic sample. Twenty-one of twenty-three (91%) biopsies in the calvarium were initially diagnostic, with one false-negative and one non-diagnostic sample. In the orbit, 4/4 biopsies were diagnostic. The total complication rate for the cohort was 4/61 (6.6%). Three complications were reported in skull base procedures (2 immediate and 1 delayed). A single complication was reported in a calvarial biopsy, and no complications were reported in orbital biopsies.
Percutaneous CT-guided core needle biopsies can be performed safely and with a high diagnostic yield for lesions in the skull base, calvarium, and orbit.
尽管颅骨、颅底和眼眶的CT引导下活检术较为常用，但此类手术的最佳入路、疗效和安全性在文献中仍鲜有描述。这项经皮活检的回顾性研究阐述了针对具有挑战性的活检靶点的几种入路，并对手术规划考量因素和组织病理学取材率进行了综述。
对2010年1月1日至2020年10月30日期间颅骨、颅底和眼眶的CT引导下活检进行回顾性研究。记录患者人口统计学和手术相关因素，包括病变大小和位置、活检入路和穿刺针规格。还记录了结果，包括CT剂量长度乘积、并发症和组织病理学取材率。
最终分析纳入61例CT引导下活检：34例颅底病变、23例颅骨病变和4例眼眶病变。颅底病变的初始诊断取材率为32/34（94%），有1例假阴性和1例未明确诊断的样本。颅骨活检中23例中有21例（91%）初始诊断明确，有1例假阴性和1例未明确诊断的样本。眼眶活检中，4/4例诊断明确。该队列的总并发症发生率为4/61（6.6%）。颅底手术报告了3例并发症（2例即刻并发症和1例延迟并发症）。颅骨活检报告了1例并发症，眼眶活检未报告并发症。
经皮CT引导下的粗针活检对于颅底、颅骨和眼眶病变可安全实施且诊断取材率高。
