CT引导下经皮穿刺活检骨恶性纤维组织细胞瘤的临床应用和诊断价值的初步探讨

目的骨恶性纤维组织细胞瘤通过CT引导下穿刺活检病理与临床手术病理结果对比研究,考察其临床应用价值和分析影响诊断的各种因素。方法对比研究14例恶性纤维组织细胞瘤在CT引导下经皮穿刺活检取得病理结果及临床手术病理结果。结果 14例穿刺针均在位,穿刺成功,均获得穿刺病理诊断及手术病理诊断,11例穿刺结果和手术结果相符,3例不相符,其组织学定性的准确率为79.8%（11/14）。结论恶性纤维组织细胞瘤临床、影像学诊断较难,需要结合组织细胞的病理确诊,CT引导下经皮穿刺活检可以在微创情况下获得明确诊断恶性纤维组织细胞瘤的病理组织,具有较高的诊断价值,但是病变的组织学类型有关和取材的局限性是影响诊断准确性的重要因素,也是造成确诊困难甚至误诊的主要原因。需要密切结合临床及影像学表现。

Clinical application and the diagnostic value of CT-guided percutaneous biopsy of bone malignant fibrous histiocytoma

Objective To explore the clinical value and the various factors affecting diagnosis of CT-guided biopsy of bone malignant fibrous histiocytoma.Methods Fourteen cases of malignant fibrous histiocytoma received CT-guided percutaneous biopsy to obtain pathological findings,and the results were compared with surgery pathology.Results All cases achieved success in percutaneous biopsy.The surgery results were conformed to biopsy in 11 cases,but not in the other 3 cases.Its accuracy rate was 79.8%.Conclusion The clinical and radiological diagnosis of malignant fibrous histiocytoma is difficult,and pathological diagnosis is need.CT-guided percutaneous biopsy of the malignant fibrous histiocytoma is a feasible and effective method for diagnosis.