开放式MR实时透视技术在颅脑病变穿刺活检中的应用效果

Application effect of open MR and real-time technique-guided biopsy of brain lesions

目的探讨开放式MR实时透视技术在颅脑病变穿刺活检中的应用价值。方法回顾性分析112例接受1.0T开放式MR实时透视引导颅脑病变穿刺活检患者,以活检后外科手术病理结果或随访结果作为最终诊断标准,计算穿刺活检诊断颅脑病变的准确率、敏感度、特异度、阳性预测值及阴性预测值。结果112例患者共穿刺112个病灶,最大径0.91~4.53 cm,平均(2.32±0.81)cm;其中29例病灶最大径≤1.5 cm,83例>1.5 cm。112例均成功取材,对其中108例获得明确穿刺病理学诊断结果。穿刺术中4例出现少量颅内出血,未见其他严重并发症,并发症发生率为3.57%(4/112)。穿刺活检诊断准确率、敏感度、特异度、阳性预测值及阴性预测值分别为96.43%(108/112)、96.34%(79/82)、96.67%(29/30)、98.75%(79/80)及90.63%(29/32),最大径≤1.5 cm与>1.5 cm病灶诊断准确率、敏感度、特异度、阳性预测值及阴性预测值差异均无统计学意义(P均>0.05)。结论1.0T开放式MR实时透视引导颅脑病变穿刺活检安全、可行。

Objective To explore the application effect of 1.0T open MR and real-time technique-guided biopsy of brain lesions.Methods Data of 112 patients with brain lesions who underwent 1.0T open MR real-time technique-guided puncture biopsy were analyzed retrospectively.The pathological results after surgical operation or follow-up results were taken as the final diagnostic criteria.The diagnostic accuracy,sensitivity,specificity,positive predictive value(PTV),negative predictive value(NPV)of puncture biopsy in diagnosis of cerebral lesions were calculated.Results Among 112 lesions in 112 patients,the maximum diameter of lesions was 0.91-4.53 cm,with an average of(2.32±0.81)cm,which was≤1.5 cm in 29 cases and>1.5 cm in 83 cases.All biopsy specimens were technically successfully obtained.And 108 procedures yielded definitive diagnoses.In 4 cases,small amount of intracranial hemorrhage was observed during the puncture,and no other serious complication was found,and the complication rate was 3.57%(4/112).The diagnostic accuracy,sensitivity,specificity,PTV and NPV were 96.43%(108/112),96.34%(79/82),96.67%(29/30),98.75%(79/80)and 90.63%(29/32),respectively.No significant difference was detected between lesions>1.5 cm and those≤1.5 cm(all P>0.05).Conclusion 1.0T open MR real-time technique-guided biopsy of brain lesions is safe and feasible.