高场封闭式MR导向穿刺活检的应用初探

Percutaneous Puncturing Biopsy Under High-Field MR Guidance:A Preliminary Study

目的探讨高场MR导向穿刺活检的临床应用价值。方法回顾性分析高场MR导向穿刺活检的62例患者,对穿刺针的使用、穿刺时间、穿刺部位等方面进行经验总结,并对其穿刺活检结果与术后组织病理学诊断结果以及临床随访结果进行对照分析。结果 62例患者活检中,52例(83.9%)在20 min内完成;38例(61.3%)使用非兼容性活检针。穿刺活检的部位包括胸部42例,腹部12例,骨关节8例。62例患者成功获得足够组织标本。最终确诊55例,7例不能确诊,穿刺活检患者总符合率为88.7%(55/62)。所有术者并发症中,出现针道及病灶周围出血8例(12.9%)。在42例肺部穿刺活检患者中,气胸3例(7.1%),其中1例行微创性胸腔闭式引流,术后少量咯血5例(11.9%),。未发现致命性并发症。结论高场MR导向活检是一种安全、方便、准确的方法,值得推广与应用。

Objective To investigate the value of percutaneous puncturing biopsy under high-field MR guidance in clinical practice. Methods Percutaneous puncturing biopsy under high-field MR guidance was employed in 62 patients. The clinical data were retrospectively analyzed with a focus on the use of puncture needle, the puncturing time, the puncture site, etc. The puncture biopsy results were compared with histopathological diagnosis and clinical follow-up observation. Results Among the 62 cases, the procedure was completed in 20 minutes in 52 （84%）, MR non-compatible biopsy needle was used in 38 （61%）. The puncture sites included thorax （ n = 42） , abdomen （ n = 12 ） and joint （ n = 8 ）. Sufficient specimen was successfully obtained in all 62 patients. The diagnosis was finally confirmed in 55 cases and could not be confirmed in 7 cases. The total accordance rate was 88.7% （55/62）. Complications included hemorrhage around the nee- dle path or the lesion （12.9%） , pneumothorax （7.1% , 3/42） and mild hemoptysis （11.9% , 5/42）. No fatal complications occurred. Conclusion Percutaneous puncturing biopsy under high-field MR guidance is a safe, reliable and accurate diagnostic method. This technique should be recommended in clinical practice.