MRI导向立体定向活检术在颅内病变诊断中的应用

Application of MRI-guided stereotactic biopsy in the diagnosis of intracranial lesions

目的探讨MRI引导下立体定向活检手术在颅内病灶诊断的准确性、安全性及其临床应用价值。方法回顾性分析52例病变性质不明的颅内病变病人的临床资料,在MRI导向下行立体定向活检术。结果 52例病人均取得病理诊断,活检成功率100%。星形细胞瘤20例(38.5%),脑转移瘤13例(25.0%),脑非化脓性感染10例(19.2%),非霍奇金淋巴瘤4例(7.7%),胶质细胞增生2例(3.8%),脑真菌病、脑囊尾蚴病及结核性病变各1例(1.9%)。术后无一例出现严重并发症。除1例放弃治疗,其余病人转相应专科治疗。结论对于难以行开颅手术的颅内疑难病变,MRI导向立体定向活检手术可提供一种可靠的诊断手段,为临床进一步诊疗提供理论依据。

Objective To explore the accuracy, safety and clinical application of MRI-guided stereotactic biopsy in intracranial lesions. Methods Clinical data of 52 patients with brain lesions of uncertain nature were analyzed retrospectively, who underwent MRI-guided stereotactic biopsy. Results Pathological diagnosis was conducted in all the patients and the successful biopsy rate was 100%. The pathological results were as follows： astrocytoma in 20 patients （38.5%）, brain metastasis in 13 （25.0%）, nonpurulent brain infection in 10 （19.2%）, non-Hodgkin lymphoma in 4 （7.7%）, gliosis in 2 （3.8%）, brain mycosis 1 （1.9%）, brain cysticercosis in 1 （1.9%） and brain tuberculous lesions in 1 （1.9%）. No severe complications occurred after surgery. All the patients but one who gave up his treatment were transferred to the corresponding special departments. Conclusions MRI-gnided stereotactic biopsy can provide a reliable method for diagnosing complicated intracranial lesions which can not be operated and theoretical basis for clinical diagnosis and treatment.