【摘要】 目的:评估CT导引经皮穿刺活检对脊柱病变的诊断价值。方法:回顾性分析行CT导引经皮穿刺并经手术病理证实的103例脊柱病变患者的病例资料。103例中良性病变60例,恶性病变43例。活检部位包括颈椎7例、胸椎34例、腰椎52例和骶椎10例。穿刺活检要点为选择最佳层面和穿刺点以及多点穿刺。患者的体位(仰卧位或俯卧位)和活检路径取决于病灶部位。穿刺针为Ackermann针,有17例辅助使用抽吸针。活检标本送病理科进行细胞病理学检查。结果:103例活检术中穿刺针均安全地穿刺入病变内,活检成功率为100%。穿刺活检正确诊断89例,假阴性11例,假阳性3例,总的诊断符合率为86.4%,恶性和良性病变分别为90.69%和83.33%,差异无统计学意义(χ2=1.157,P>0.05);对颈椎、胸椎、腰椎和骶椎病变的诊断符合率分别为85.71%,79.41%,90.38%和90.00%。所有患者未发生严重并发症。结论:CT导引经皮穿刺活检是诊断脊柱病变的安全有效的方法。更多还原

【Abstract】 Objective:To explore the diagnostic value of CT-guided puncture biopsy in spinal lesions.Methods:The clinical data of 103 patients with spinal lesions confirmed by surgery and pathology were retrospectively analyzed.All patients underwent CT-guided percutaneous puncture biopsy.Of 103 cases,there were 60 benign lesions and 43 malignant lesions.The level of spinal biopsy was cervical segment in 7cases,thoracic in 34 cases,lumbar in 52 cases and sacral in 10 cases.The key points of puncture biopsy included precise selection of cross-section and point of puncture and multipoint puncture.The patient′s position(supine or prone)and puncture path were designed according to the location of each lesion.Ackermann needle was used for all patients,sometimes(n=17)combined with the aspiration needle.Biopsy specimens were sent for cytopathology.Results:All lesions were safely biopsied with successful rate of 100%.89 cases were diagnosed correctly by the biopsy with false-negative result in 11 cases and false-positive result in 3cases.The diagnostic accuracy for all,malignant and benign lesions was 86.4%,90.69% and 83.33%,respectively,there was no statistic difference between malignant and benign group(χ2=1.157,P>0.05).The diagnostic accuracy was 85.71%,79.41%,90.38%,and 90.00%for the lesions located in the cervical,thoracic,lumbar and sacral spine.No severe complications were observed in this series.Conclusion:CT-guided spinal biopsy is a safe and effective method for diagnosis and differential diagnosis of spinal lesions.更多还原