Husband J E, Golding S J
Clin Radiol. 1983 May;34(3):255-60. doi: 10.1016/s0009-9260(83)80323-7.
Sixty percutaneous biopsies have been carried out on patients with known or suspected malignant disease, using computed tomography (CT) for needle guidance. We describe our technique of obtaining material for histological or cytological examination using four types of needle. The results in 50 patients have been analysed to show the accuracy of the technique and evaluate its role in management. Malignancy was correctly diagnosed in 27 patients and correctly excluded in 12 patients, with one technical failure. The technique failed to demonstrate malignancy in 11 patients, all of whom proceeded to an alternative biopsy technique on clinical grounds. All false negative examinations occurred when fine-needle aspiration provided material for cytological examination only. The technique had an overall accuracy of 78%. Biopsy of retroperitoneal lymph nodes may be difficult technically. False negative examinations are particularly likely when fine-needle aspiration is used in patients with lymphoma. Chemotherapy or radiotherapy was started in 21 patients as a result of the procedure and chemotherapy changed to an appropriate regime in two patients. Treatment, including surgery, was deferred in 14 patients. Surgery was avoided when CT showed an inoperable lesion and where biopsy confirmed active metastases. Computed tomography-guided biopsy is an accurate, safe and effective technique: CT should be used for needle guidance in those situations where fluoroscopy or ultrasound are less reliable.
我们对60例已知或疑似患有恶性疾病的患者进行了经皮活检，采用计算机断层扫描（CT）引导穿刺针。我们描述了使用四种类型的针获取组织学或细胞学检查材料的技术。分析了50例患者的结果，以显示该技术的准确性并评估其在治疗中的作用。27例患者被正确诊断为恶性肿瘤，12例患者被正确排除恶性肿瘤，有1例技术失败。该技术在11例患者中未能显示出恶性肿瘤，所有这些患者均根据临床情况采用了另一种活检技术。所有假阴性检查均发生在细针穿刺抽吸仅提供细胞学检查材料时。该技术的总体准确率为78%。腹膜后淋巴结活检在技术上可能具有挑战性。当对淋巴瘤患者使用细针穿刺抽吸时，特别容易出现假阴性检查。21例患者因该操作开始化疗或放疗，2例患者的化疗方案改为合适的方案。14例患者推迟了包括手术在内的治疗。当CT显示病变无法手术且活检证实有活跃转移时，避免了手术。计算机断层扫描引导下的活检是一种准确、安全且有效的技术：在荧光透视或超声不太可靠的情况下，应使用CT引导穿刺针。
