CT引导下经皮穿刺活检在骨骼病变中的应用价值

Clinical Value of CT-Guided Percutaneous Needle Biopsy in the Diagnosis of Bone Diseases

目的:评价CT引导下经皮穿刺活检在骨骼病变中的诊断价值。方法:对108例骨骼病变行CT引导下活检,每例常规取材2～3次,其中62例病灶区域灶周硬化明显者采用Ackermann骨钻针,35例破坏灶或有明显骨皮质薄弱区者采用切割式活检针,11例有明显灶区液化者采用抽吸式活检针。结果:108例中102例获得病理诊断,穿刺活检取材阳性率为94.3%,其中97例穿刺结果与手术病理结果相符、5例不相符,其组织学定性诊断符合率为95.0%。6例假阴性者包括4例增生硬化性病灶、2例为液化灶。结论:CT引导下经皮穿刺活检在骨骼病变中的应用安全可靠,并发症少,可得到准确的病理诊断。

Objective： To assess the clinical value of CT-guided percutaneous needle biopsy in the diagnosis of bone diseases. Methods：CT-guided percutanneous bone needle biopsy was performed in 108 cases with bone diseases. Samples were collected routinely for 2 or 3 times in each case. Ackermann needle was used in 62 cases with lesions showing obvious peripheral sclerosis. Core cutting needle was used in 35 cases having lesions with destruction or thin cortex. Fine needle for aspiration was used in 11 cases with cystic lesions or lesions with obvious liquefied areas. Results：Of these 108 patients, 102 patients had samples acquired successfully for pathology diagnosis with the positive rate as 94.3%. The diagnosis of biopsy in these 102 cases were in accordance with pathology after surgery in 97cases （95.0%）. There were false negative in 6 patients,including sclerotic lesion （4 cases） and liquefied lesion （2 cases）. Conclusion：CT-guided percutaneous bone needle biopsy was a safe and effective method for acquiring accurate pathology diagnosis of bone diseases with rare complications.