Kruyt R H, Oudkerk M, van Sluis D
Department of Radiology, Daniel den Hoed Cancer Center, University Hospital Rotterdam, The Netherlands.
J Comput Assist Tomogr. 1998 Mar-Apr;22(2):276-81. doi: 10.1097/00004728-199803000-00022.
In this article we report our experience with CT-guided bone biopsy (CTGBB) using a new nondisposable bone biopsy device with in a uniform protocol for all lesions and compare our results with data from bone biopsies obtained with other techniques. With this biopsy device, the specimen is collected in a 20 x 2 mm chamber of an apple corer-shaped needle. In 46 consecutive cancer patients that were candidates for bone biopsy, 50 CTGBB procedures were performed and analyzed. Lesions with cortical defects and/or surrounding soft tissue infiltration were excluded. There were no complications. Of 50 CTGBB procedures, 90% were diagnostic. Four of the five inconclusive biopsies were repeated: All were conclusive, one malignant. Of 19 with CT-indistinguishable lesions (detected on MRI or isotope studies), 35% were malignant. Thirty-eight percent of the lesions were not accompanied by pain. The procedure was less painful than injection of the local anesthetic prior to biopsy in 90% of the cases. With the new device, CTGBB procedures can be carried out safely. Biopsy with the described technique has a high diagnostic output, better results than those of biopsy with reported uniform techniques, and equal results to the best results of combined techniques. If a lesion is not distinguishable on CT and/or not accompanied by pain, malignancy is not ruled out. CTGBB in the described technique is less or equally time consuming, less painful, and cheaper than reported for other bone biopsy procedures.
在本文中，我们报告了使用一种新型非一次性骨活检设备进行CT引导下骨活检（CTGBB）的经验，该设备针对所有病变采用统一方案，并将我们的结果与其他技术获取的骨活检数据进行比较。使用这种活检设备，标本收集在苹果去核器形状针的20×2毫米腔室中。在46例连续的适合进行骨活检的癌症患者中，进行并分析了50例CTGBB操作。排除有皮质缺损和/或周围软组织浸润的病变。无并发症发生。在50例CTGBB操作中，90%具有诊断价值。5例不确定活检中有4例进行了重复活检：均为确定性结果，其中1例为恶性。在19例CT上难以区分的病变（在MRI或同位素检查中发现）中，35%为恶性。38%的病变无疼痛症状。在90%的病例中，该操作比活检前注射局部麻醉剂的疼痛程度轻。使用这种新设备，CTGBB操作可以安全进行。采用所述技术进行活检具有较高的诊断率，比报道的统一技术活检效果更好，与联合技术的最佳效果相当。如果病变在CT上难以区分和/或无疼痛症状，不能排除恶性可能。所述技术的CTGBB比其他骨活检操作耗时更少或相当，疼痛程度更轻，成本更低。
