头颅磁共振成像引导幕上病变活检103例*

  目的  探讨磁共振成像（magnetic resonance imaging，MRI）引导下微钻钻孔立体定向活检术在颅内占位性病变的应用。  方法  回顾性分析2009年11月至2013年12月就诊于首都医科大学三博脑科医院103例因脑幕上病变行MRI引导微钻钻孔立体定向活检手术的患者，分析病变的病理结果及患者术后情况。  结果  102例患者均获取明确的病理诊断，活检阳性率99.0%，其中胶质瘤66例（65.0%），淋巴瘤27例（26.5%），横纹肌肉瘤1例（1.0%），生殖细胞肿瘤3例（2.9%），炎性病变3例（2.9%），脑灰质异位2例（2.0%），脑梗塞1例（1.0%）。3例患者术后出现穿刺部位出血（2.9%），1例（1.0%）需行手术清除血肿，无死亡病例，无术后感染病例。  结论  磁共振引导微钻钻孔脑立体定向活检术是一种安全、可靠、微创的手术方法，对颅内病变的诊断与治疗具有重要意义。 

MRI-guided stereotactic supratentorial lesion biopsy:a report of 103 patients

To evaluate the reliability and accuracy of MRI-guided stereotactic biopsy for supratentorial brain lesions. Method: A total of 103 cases of MRI-guided biopsy were performed between November 2009 and December 2013. Patients' pathological results and postoperative rehabilitation courses were analyzed. Results: A total of 102 patients (99.0%) had pathological results, of which 97 cases were brain tumors (86.0%), including 36 cases of astrocytoma, 9 cases of anaplastic astrocytoma, 10 cases of oligoastrocytoma, 4 cases of anaplastic oligoastrocytoma, 4 cases of anaplastic ligodendroglioma, 3 cases of glioblastoma multiforme, 27 cases of lymphoma, 3 cases of germcell tumors, and 1 case of rhabdomyosarcoma. Inflammatory lesions were found in 3 cases (2.9%). Displacement of brain gray matter was reported in 2 cases (2.0%), and 1 case (1.0%) of cerebral infarction existed. A total of 3 patients suffered intracranial hematoma after biopsy, and 1 patient underwent craniotomy to remove the hematoma. No death or intracranial inflammation occurred after biopsy.Conclusion: MRI-guided stereotactic biopsy is a safe and reliable method in qualitative diagnosis. It is a very important tool for diagnosis and treatment selection for intracranial lesions.