CT引导下经皮穿刺活检在肌骨病变中的诊断价值

The diagnostic value of CT-guided percutaneous biopsy in the musculoskeletal system

目的:评价CT引导下经皮穿刺活检在骨骼肌肉系统病变中的诊断价值。方法:在CT引导下经皮穿刺活检骨骼肌肉系统病变319例。结果:273例获得病理诊断,占85.6%(273?319),29例穿刺取得的病理组织不足,占9.1%(29?319),17例穿刺活检不成功,占5.3%(17?319)。257例具手术病理结果的病例中,212例穿刺结果和手术结果相符,45例不相符,其组织学定性的准确率为82.5%(212?257)。结论:CT引导下经皮穿刺活检是骨骼肌肉系统病变有效的诊断方法,可以使大多数患者避免切开活检;诊断的准确性和病变的组织学类型有关,少见病和取材的局限性是病理确诊困难甚至误诊的主要原因,而囊性和硬化性病灶是活检失败的主要原因。

Objective:To analyze the diagnostic value of CT-guided percutaneous biopsy in the musculoskeletal system.Methods:CT-guided percutaneous biopsy was performed in319patients with musculoskeletal lesions.Results:In273(85.6%)patients,pathologic results were obtained,in29(9.1%)cases,no results of pathology were obtained owing to having not e-nough samples,in17(5.3%)cases,no results were obtained owing to not able to acquire samples.In257cases,pathologic re-sults were obtained subsequently at surgery,in212cases,percutaneous biopsy results were consistent with surgery(82.5%),in45cases(17.5%)the biopsy result s were not consistent with the results of surgery.Conclusion:CT-guided percutaneous biopsy is effective for the diagnosis of musculoskeletal system.Open biopsy can be obviated in the majority of cases.The diagnostic ac-curacy was related to the lesion’s pathologic type.The majority cases of unsuccessful biopsy were in the cystic and sclerotic le-sions.