胸腰椎病变CT监视下穿刺活检路径分析

On approaches of CT-guided percutaneous biopsy of thoracic and lumbar spine

目的探讨胸腰椎病变CT监视下穿刺活检中穿刺路径的选择方法。方法141例胸腰椎病变临床诊断不清患者,其中胸椎70例,腰椎71例。根据病变位于脊椎的不同部位选择合适的穿刺路径,于CT监视下穿刺取材。穿刺路径:经椎旁路径63例,经椎弓根路径45例,经肋椎关节路径11例,其他路径22例。结果141例中共有128例诊断正确,穿刺结果诊断正确率为90.8%。无并发症发生。结论胸腰椎病变穿刺路径的选择要根据病变的位置不同具体分析。总的原则是安全、取材量多、对患者损伤小。

Objective To discuss the selection of approaches for CT-guided percutaneous biopsy of thoracic and lumbar spine. Methods One hundred and forty-one cases of thoracic （70 cases ） or lumbar （71 cases ） vertebral undiagnosed lesions underwent CT-guided percutaneous biopsy. Appropriate needle approaches were designed according to different locations of lesions in the vertebra, including 63 cases of paravertebral path, 45 cases of transpedicular path, 11 cases of transcostovertebral path, and 22 eases of other paths. Results Out of the 141 cases, a definite diagnosis was obtained in 128 cases. The diagnostic accuracy of biopsy was 90. 8%. No complications occurred. Conclusions The needle approach for CT-guided percutaneous biopsy of the thoracic and lumbar spine should be selected according to different locations of lesions, which should be based on principles of safety, enough specimen, and minimally invasive to patients.