CT导引经皮肌肉骨骼穿刺活检(102例报道)

CT-guided Percutaneous Biopsy of Musculoskeletal Lesions:102 Cases Report

目的:探讨CT导引下经皮肌肉骨骼穿刺活检操作技术,评价其在肌肉骨骼病变诊断的价值。方法:102例CT引导下肌肉骨骼穿刺活检病例均行2-3点取材,肌肉软组织穿刺活检45例,骨骼穿刺活检例57例、其中骨骼并软组织穿刺活检40例。所有病例有手术、切开活检病理或临床随访资料。结果:102例肌肉骨骼病变的穿刺活检总正确率为83.3%(85/102)。软组织、骨骼病变穿刺活检正确率分别为95.6%(43/45)、71.9%(41/57),其中骨骼并软组织穿刺活检正确率95.0%(38/40),软组织与骨骼病变间比较差异有统计学意义(P<0.05)。大病灶(直径>3 cm)组、小病灶(直径≤3 cm)组穿刺活检正确率分别为88.7%(55/62)、75.0%(30/40),二者之间比较差异有统计学意义(P<0.05)。结论:CT导引下经皮肌肉骨骼活检是一种安全、简便、有效的诊断和鉴别诊断方法,对大病灶诊断准确率优于小病灶,多点及多种成分取材能提高正确率。

Objective. To evaluate the clinical applications and role of CT-guided percutaneous biopsy in musculoskeletal lesions. Methods. A total of 102 musculoskeletal lesion cases underwent 2- or 3- point CT-guided percutaneous biopsy, including 45 cases of soft tissue lesions and 57 cases of bone lesions. All cases were identified pathologically by surgery, open biopsy or had clinical follow-up information. Results. The accuracy of CT-guided percutaneous biopsy was 83.3% （85/ 102）. The accurate rate for soft tissue and bone biopsies was 95.6%（43/45） and 71.9% （41/57） respectively, and that for the bone plus soft tissue biopsy was 95.0%（38/40）. Significant differ- ences were found in accurate rates by different biopsy in bone and soft tissue（P〈0.05）. Significant differences in accurate rate for big lesions （diameter〉3 cm） 88.7% （55/62） and small lesions （diameter≤3 cm） 75.0% （30/40） were found （P〈0.05）. Conclusion： CT-guided percutaneous biopsy is a safe, simple and effective method for the diagnosis and differential diagnosis of musculoskeletal lesions, the big lesion biopsy is superior to the small one, and multi-points or multi-tissues biopsy has a higher accurate rate.