CT导引经皮穿刺椎体活检术的临床应用

目的:探讨CT导引下脊柱椎体病变穿刺活检的取材成功率,诊断及临床应用价值,以及安全性。方法:总计37例椎体活检,其中颈椎3例,胸椎13例,腰椎16例,骶椎5例。完善DR、CT及MRI等活检前检查,尽量避开硬化性病灶。患者无论是单发病灶或是多发病灶均只取一椎体(以减少损伤,降低费用,减少检查时间)。以切割组织条为主,部分抽取病变区血液、骨髓组织送检,疑有感染则另送涂片。对穿刺标本进行正确分析。结果:CT证实穿刺针均位于病灶内,其中34例为阳性结果,3例为无法诊断,取材成功率为100%,椎体活检阳性率为91.8%。结论:CT导引穿刺病变椎体活检定位精确,并发症极少,阳性率高,是取得椎体病理诊断较为可靠的手段。

Objective:To evaluate the CT-guided biopsy of spinal lesions of the vertebral body based on the success rate, diagnostic and clinical value, as well as security. Methods: Total 37 cases of vertebral body biopsy, of which three cases of cervical, thoracic in 13 cases, 16 cases of lumbar, five cases of sacral vertebrae. Perfect DR, CT and MRI before biopsy, such as inspection, except for sclerosis lesions. Patients with lesions, whether single or multiple lesions are vertebral body, only one (to reduce injury, reduce costs, reduce inspection time). Article organizations in order to cut the main part of lesion area extraction of blood, bone marrow will be inspected, the suspect will also be transmitted infection smear. To puncture the correct analysis of specimens. Results: CT confirmed lesions were located at the needle, the one positive result for the 34 cases, three cases are unable to diagnosis, based on the success rate was 100%, vertebral body biopsy posi- tive rate of 91.8%. Conclusion: CT-guided needle biopsy of vertebral lesions precise positioning, very few complications, the positive rate, it is pathological vertebral body to obtain a more reliable means of diagnosis.