CT透视引导经椎弓根胸腰椎椎体病变穿刺活检的价值

Percutaneous coaxial transpedicular biopsy of thoracic and lumbar vertebral body lesions guided by CT fluoroscopy

目的 评价CT透视引导经椎弓根胸腰椎椎体病变穿刺活检的价值和安全性。方法 在 2 1个月中 ,我们对2 7例椎体病变患者进行CT透视引导经皮经椎弓根共轴针法椎体病变活检 ,获取组织和液体标本送检。结果 2 7例中 2 5例得到明确的组织病理学和病源学诊断 ,2例资料不足。这种方法活检的准确性 92 6% ,敏感性 96 2 % ,特异性 96 2 %。没有出现并发症。结论 CT透视引导经椎弓根共轴针胸腰椎椎体病变穿刺活检是一种安全有效的微创诊断技术 ,有助于胸腰椎病变性质的确定和治疗方案的确立。

Objective To evaluate the safety and histological results of percutaneous coaxial transpedicular biopsy of vertebral body lesions guided by CT fluoroscopy. Methods Over 21 months, percutaneous transpedicular biopsy was performed under local anesthesia in 27 cases of thoracic or lumbar vertebrae with abnormalities. All procedures were performed under CT fluoroscopic guidance, and a small amount of tissue or fluid was collected. Results For all 27 patients but two, from whom inadequate specimens were obtained, correct diagnoses were made, which were confirmed by pathological diagnoses of massive tissue obtained during subsequent reconstructive surgery and fellow-up. The accuracy rate, sensibility, and specificity of diagnosis with this biopsy method was 92.6%, 96.2%, and 96.2%, respectively. No complications were observed. Conclusion Percutaneous coaxial transpedicular biopsy guided by CT fluoroscopy is a safe, minimally invasive, and effective technique for the diagnosis of thoracic and lumbar lesions and is helpful in planning therapy.