C臂CT引导经皮骨肿瘤穿刺活检术

C-arm cone beam CT-guided percutaneous core needle biopsy of bone neoplasms

目的观察C臂CT引导经皮穿刺骨肿瘤活检术的临床价值。方法回顾性分析283例接受C臂CT引导经皮穿刺活检术的骨肿瘤患者,计算穿刺活检成功率、并发症发生率、手术时间及辐射剂量;以最终病理结果为标准,计算诊断敏感度、特异度及准确率,分析C臂CT引导穿刺活检诊断良恶性骨肿瘤的效能。结果C臂CT引导经皮骨肿瘤穿刺活检术成功率100%,总手术时间(14.10±5.95)min,辐射剂量(11.21±4.12)mSv。283例中,3例(1.06%)轻微出血,80例(28.27%)术后轻度疼痛。经皮骨肿瘤穿刺活检术诊断骨肿瘤的敏感度为90.82%、特异度为86.97%,其准确率(89.81%)与最终病理结果差异无统计学意义(χ^2=2.37,P>0.05)。结论C臂CT引导经皮骨肿瘤穿刺活检术能实时透视准确定位病变,有效进行术前规划和降低辐射剂量,值得临床推广。

Objective To observe the value of C-arm cone beam CT(CBCT)-guided percutaneous core needle biopsy(PCNB)of bone neoplasms.Methods Imaging and pathological data of 283 patients who underwent CBCT-guided PCNB of bone neoplasms were retrospectively analyzed.The success rate,incidence of complication,operation time,radiation dose,as well as diagnostic sensitivity,specificity and accuracy of CBCT-guided PCNB were calculated,and the diagnostic efficacy of CBCT-guided PCNB of bone neoplasms was analyzed based on final pathological results.Results The success rate of CBCT-guided PCNB of bone neoplasms was 100%,with operation time of(14.10±5.95)min and radiation dose of(11.21±4.12)mSv.Among 283 patients,minor bleeding occurred in 3(1.06%)patients,while 80 patients(28.27%)had mild pain after operation.Taken the final pathological results as standards,the sensitivity and specificity of CBCT-guided PCNB in diagnosis of benign and malignant bone tumors was 90.82%and 86.96%,respectively,with accuracy(89.81%)not statistical different from final pathological results(χ^2=2.37,P>0.05).Conclusion CBCT guigance can provide real-time fluoroscopy for accurate localization during PCNB of bone neoplasms,therefore effectively carry out preoperative planning and reduce radiation dose,being worthy of clinical promotion.