脑深部病变立体定向活检方法的研究

目的 探讨用脑神经成像技术引导的立体定向脑深部病变活检术获取组织病理学诊断的可靠性和正确性。方法 采用CT、MRI与立体定向相结合,进行了脑深部病变的靶点活检手术,共605例,其中450例用CT或MRI片目测靶点坐标定位,155例采用计算机辅助的立体定向手术（CAPN）工作站,自动计算靶点和规划活检手术。结果 537例（88.75%）获得脑肿瘤的组织病理诊断,30例（4.96%）为炎性病理,18例（2.98%）为其他组织,20例（3.31%）未能提供可供确诊的病理,阳性诊断率为96.69%,死亡2例（0.33%）,并发症13例（2.14%）。结论 用成像技术引导的立体定向对脑深部病变活检是神经内外科获得定性诊断安全及可靠的手术方法,值得广泛推广应用。

Stereotactic biopsy for intracranial deep lesions

Objective To investigate the histological diagnostic efficacy and accuracy of stereotactic biopsy for intracranial deep lesions under computerized tomography (CT) and magnetic resonance imaging (MRI) guidance. Methods CT or MRI guided stereotactic biopsy was performed in 605 cases with intracranial deep lesions. All the procedures were done under local anesthesia with Leksell stereotactic system. CT or MRI film was used to determine the coordinate in 450 cases and the computer assisted planning for neurosurgery (CAPN) in 155 cases. Results Brain tumors, inflammatory lesions, and abnormal but nonspecific lesions were diagnosed pathologically in 537 cases (88 75%), 30 cases (4 96%), and 13 cases (2 15%) respectively In 20 cases (3 31%) the biopsy procedure failed to provide useful pathological evidence. The total positive rate of biopsy was 96 69%. Complications associated with biopsy occurred in 18 patients (2 98%), and 2 patients (0 33%)died following the procedure. Conclusion Stereotactic biopsy using MRI guided stereotactic approach or CT guided technique is a safe and reliable method for histological diagnosis of intracranial deep lesions.