Bernardi L, Castellan L
Istituo di Neuroradiologia, Ospedale S. Bortolo, Vicenza.
Radiol Med. 1995 Jun;89(6):831-4.
The results were reviewed of 81 percutaneous trephine biopsies performed under fluoroscopic or CT guidance from January, 1989, to August, 1994, in 78 patients with thoracic or lumbar vertebral lesions. All the patients presented abnormal findings at conventional radiography and questionable CT or MR findings. A fine-needle sample was obtained as a complementary tool in 9 patients and material for microbiologic culture in 5 patients. Clinical and pathologic findings were correlated for each patient. Biopsy always permitted to obtain sufficient material for the histologic examination; its overall accuracy was 91%. The technique exhibited the highest diagnostic sensitivity in vertebral tumors (100%) and the lowest sensitivity in vertebral infections (69%). Complementary fine-needle sampling was useful especially in small osteolytic lesions, while the microbiologic examination was often negative. There was only one pneumothorax due to the maneuver. To conclude, percutaneous trephine biopsy of thoracic and lumbar spine lesions is a valuable tool for tumor diagnosis which usually spares the patients open surgery.
回顾了1989年1月至1994年8月期间在透视或CT引导下对78例胸腰椎病变患者进行的81次经皮环钻活检的结果。所有患者在传统放射学检查中均有异常发现，CT或MR检查结果存疑。9例患者获取细针样本作为辅助手段，5例患者获取用于微生物培养的材料。对每位患者的临床和病理结果进行了关联分析。活检总能获取足够的材料用于组织学检查；其总体准确率为91%。该技术在椎体肿瘤中的诊断敏感性最高（100%），在椎体感染中的敏感性最低（69%）。辅助细针采样尤其适用于小的溶骨性病变，而微生物学检查往往为阴性。操作过程仅导致1例气胸。总之，胸腰椎病变的经皮环钻活检是肿瘤诊断的一种有价值的工具，通常可使患者免于开放性手术。
