CT 引导下椎体穿刺活检诊断准确率的相关因素分析

目的：探讨 CT 引导下椎体穿刺活检诊断准确率的影响因素。方法收集128例行 CT 引导下椎体穿刺活检术患者的临床及病理资料,采用多因素 Logistic 回归分析方法,分析患者相关因素(性别、年龄)、病灶相关因素(部位、骨质破坏性质、病灶内有无坏死囊变、有无钙化或骨化)、操作相关因素(取材大小、靶点位置)对穿刺活检诊断准确率的影响。结果128例患者穿刺活检诊断准确率为86.7%(111/128)。多因素回归分析结果显示病灶骨质破坏的性质(OR=3.428,P =0.038)、病灶内是否伴有坏死囊变(OR=0.193,P =0.012)、是否伴有钙化或骨化(OR=0.266,P =0.036)以及活检取材量大小(OR=0.200,P =0.015)4个因素被纳入穿刺活检诊断准确率的回归方程。结论CT 引导下椎体穿刺活检具有较高的诊断准确率,病灶骨质破坏的性质、病灶内是否伴有坏死囊变、钙化或骨化及活检取材量大小是穿刺活检诊断准确率的独立影响因素。

Analysis of correlative factors of diagnostic accuracy for CT-guided percutaneous biopsy of spine lesions

Objective To investigate the diagnostic accuracy factors for CT-guided percutaneous biopsy of spine lesions.Methods The clinical and pathological data of 128 patients who were undergone CT-guided percutaneous biopsy of spine lesions were collected.The multivariate stepwise Logistic retrospective study was performed to study the influence of the patient-related factors (sex,age),lesion-related factors (location,bone destruction characteristics,with or without necrosis,with or without calcification),and procedure factors (punc-ture target spot,tissue specimen size)on the diagnostic accuracy.Results The diagnostic accuracy rate of CT-guided percutaneous biopsy of spine lesions was 86.7% (1 1 1/128 ).By multi-factor analysis,bone destruction characteristics (OR = 3.428,P = 0.038 ),with or without necrosis (OR=0.1 93,P =0.012),with or without calcification (OR=0.266,P =0.036),tissue specimen size (OR=0.200, P =0.01 5)were incorporated into the regression equation of the diagnostic accuracy.Conclusion CT-guided percutaneous biopsy of spine lesions has a high diagnostic accuracy.Bone destruction characteristics,with or without necrosis,with or without calcification, tissue specimen size are the independent factors.