表观弥散系数影像自动融合指导无框架立体定向颅内穿刺活检

Automated apparent diffusion coefficient imaging guided frameless stereotactic biopsy of intracranial lesions: A preliminary experience

目的探讨基于表观弥散系数（apparent diffusion coefficient,ADC）影像自动融合指导的无框架立体定向活检技术在颅内病变活检中的应用价值。方法连续选取我院2015年1-7月因临床诊断困难需行活检的脑肿瘤病例16例,其中男性9例,女性7例;年龄9~78岁,平均46岁,均进行ADC影像自动融合的无框架立体定向活检术。结果 16例均成功实施活检,ADC图标记靶点平均每例耗时2 min 7 s,单个靶点平均耗时1 min 53 s。患者均获得明确病理诊断,诊断阳性率为100%。所有病例穿刺后靶点均未发现血肿,术后无新发神经功能障碍。结论基于ADC影像自动融合指导的无框架立体定向活检技术在颅内病变活检中具有较高的病理诊断阳性率,标记靶点简便快捷,在提高手术准确性、安全性方面有一定优势。

Objective To evaluate the feasibility and accuracy of automated apparent diffusion coefficient imaging guided frameless stereotactic biopsy of intracranial lesions. Methods From January to July in 2015, a consecutive series of 16 patients with intracranial lesions diagnosed by biopsy were prospectively enrolled. The cohort consisted of 9 males and 7 females with a mean age of 46 years（ranged from 9 to 78 years）. All patients had undergone apparent diffusion coefficient（ADC） imaging-guided biopsy. Results ADC imaging-guided biopsy was successfully implemented in all cases. It took 2 minutes 7 seconds for single patient and 1 minute 53 seconds for single target to delineate targets using ADC imaging. All cases got a clear pathological diagnosis with the diagnosis positive rate of 100%. Intracerebral hematoma and worse neurological deficits was not found after surgery. Conclusion ADC imaging-guided frameless stereotactic biopsy of intracranial lesions has a high pathological diagnosis positive rate. The target can be selected efficiently according to the ADC imaging of the lesion with high accuracy and safety.