CT介导同轴套管针脊柱病变经皮活检术

目的探讨CT介导同轴套管针经皮活检术在脊柱病变临床诊治中的价值。方法CT引导下同轴穿刺套管针经皮穿刺活检脊柱病变37例,其中胸椎9例,腰椎13例,骶椎8例,胸腰椎同时累及7例。根据病变的部位,采用经椎弓根或椎旁入路,进入病变部位后旋转套管切割病变组织,送组织学检查。结果所有37例患者均穿刺成功,每例患者获穿刺组织块1～4块,平均2.1块;34例获明确诊断,分别为转移性肿瘤15例,结核9例,脊索瘤5例,多发性骨髓瘤2例,骨巨细胞瘤2例,嗜酸性细胞肉芽肿1例,成功率91.9%;无一例严重并发症。结论CT介导同轴套管针脊柱病变经皮活检术诊断率高,并发症少,且微创、安全,价格低廉,值得在临床推广应用。

C-T-guided percutaneous biopsy of thoracic and lumbar spine with coaxial needle

Objective To evaluate the percutaneous biopsy of vertebral lesion under CT guidance.Methods Thirty-seven paitents were underwent percutaneous biopsy under CT guidance,including 9 thoracic vertebral lesions,13 lumbar lesions,8 sa- cral lesions and 7 multiple lesions involving both thoracic and lumbar vertebrae.A larger bore needle and coaxial system were in- serted transpedicularly or paraspinally according to the lesion site,rotating the external sheath and the lesion tissue blocks were obtained through the external cannula.Results All 37 patients were biopsied sucessfully and 1 to 4 tissue blocks(average,2.1 blocks)were gained by each patient.Thirty-four patients got definitive pathological diagnosis,the successful rate was 91.9%, including 15 metastatic tumors,9 tuberculosises,5 chordomas,2 multiple myelomas,2 giant cell tumors and 1 eosinophilic granulo- ma.No serious complications were found.Conclusions Percutaneous vertebral biopsy under CT guidance has high rate of diagno- sis and low rate of complication.It is a safe and cheap method and deserves more clinical research and application.