微侵袭立体定向活检手术方法的研究

目的 研究应用微侵袭立体定向活检手术方法获取颅脑深部病变组织的可行性和准确性。方法 CT或MRI与立体定向技术相结合,对605例脑深部病变患者进行精确定位、活检,其中450例用CT或MRI目测靶点坐标定位,155例采用计算机辅助立体定向手术工作站,自动计算靶点坐标和规划活检手术入路。结果 活检手术后,经病理证实为脑肿瘤组织者537例(88.76％),炎性病变组织者30例(4.96％),其他病变组织18例(2.98％),另有20例(3.31％)未能提出可供病理学确诊的依据,阳性诊断率为96.69％。术后发生并发症13例(2.15％),死亡2例(0.33％)。结论 经影像学引导的立体定向活检手术是神经内外科获得颅脑深部病变定性诊断安全而可靠的方法,值得临床推广应用。

The study on minimally invasive stereotaxic biopsy for intracranial deep lesions

Objective The feasibility and accuracy of minimally invasive stereotactic biopsy for in-tracranial deep lesions was studied. Methods CT- or MRI-guided stereotactic biopsy was performed in 605 patients with intracranial deep lesions. The CT or MRI image was used in range estimation for target coordinate location in 450 cases. The computer-assisted planning for neurosurgery (CAPN) was applied in 155 cases for automatic calculating target coordinate location and planning the access of biopsy operation. Results The diagnosis was determined pathologically with biopsy as brain tumor in 537 cases (88.76%), inflammatory tissue in 30 cases (4.96%) and other lesions in 18 cases (2.98%). The rest of 20 cases (3.31%) were not diagnosed. The positive rate of diagnosis was 96.69% (585/605). Complications associated with biopsy occurred in 13 patients (2.15%) and 2 patients (0.33%) died following the procedure. Conclusion It is demonstrated that the minimally invasive stereotaxic biopsy is a safe and reliable diagnostic approach for intracranial deep lesions. It is worth to spread in clinical application.