【摘要】 目的 探讨CT引导下经皮椎体病变穿刺活检技术成功率及其临床应用价值。方法 连续采集36例椎体病变病例,影像学上表现为椎体溶骨性改变21例,成骨性改变9例,溶骨性与成骨性混合改变6例。其中病变位于颈椎2例,胸椎18例,腰椎16例。根据病变部位设计经皮CT引导下相应的穿刺体位和路径,CT动态监测穿刺针走行及位置,确定到达预定部位后穿刺活检取材。穿刺标本行细胞学及组织学检查。结果 CT显示36例穿刺针均到达预定病变部位,其中34例取得病变组织满足病理诊断(1例病变组织较少,1例未取到病变组织),活检成功率94.4%。病理结果转移瘤22例,原发性骨肿瘤9例,感染性病变3例。结论 CT引导下经皮椎体病变穿刺活检技术能清楚、准确获取病变组织,安全可靠,准确率高,可为椎体病变的诊断及鉴别诊断提供直接依据。更多还原

【Abstract】 Objective To investigate the success rate and clinical application value of CT-guided percutaneous puncture biopsy for vertebral lesions.Methods Thirty-six cases of vertebral lesions were collected consecutively.Radiographically,there were 21 cases of vertebral lytic changes,9 cases of osteogenic changes and 6 cases of mixed lytic and osteogenic changes.The lesions were located in cervical vertebra in 2 cases,thoracic vertebra in 18 cases and lumbar vertebra in 16 cases.The corresponding puncture position and path under the guidance of percutaneous CT were designed according to the lesion site,and the walking and position of the puncture needle were dynamically monitored by CT,so as to determine the biopsy samples after reaching the predetermined site.Puncture specimens were examined by cytologically and histologically.Results CT showed that the puncture needles in all 36 cases reached the predetermined lesion site,and pathological diagnosis was satisfied in 34 cases(1 case had little lesion and 1 case did not).The biopsy success rate was 94.4%.Pathological results 22 cases were metastatic tumor,9 cases were primary bone tumor and 3 cases were infectious disease.Conclusion CT-guided percutaneous puncture biopsy for vertebral lesions can clearly and accurately display the anatomical structure of the lesions and adjacent tissues,which is safe,reliable and accurate,and can provide a direct basis for the diagnosis and differential diagnosis of vertebral lesions.更多还原