Ultrasound-guided fine needle aspiration biopsy of gall bladder malignancies.

PURPOSE: To establish the safety and efficacy of US-guided fine needle aspiration biopsy (FNAB) in gall bladder malignancies. MATERIAL AND METHODS: 142 patients suspected to have gall bladder malignancies underwent FNAB under real-time US guidance. The most common sonographic appearances were a mass filling or replacing the gall bladder (n=98), focal or diffuse wall thickening (n=25) and intraluminal polypoidal mass (n=19). FNAB was performed with a 0.7-mm spinal needle using a free-hand technique. RESULTS: On initial FNAB, 115 patients were diagnosed to have malignancy. In the remaining 27 patients, aspirates on first FNAB showed either inflammatory pathology (n=14) or the sample was suspicious of malignancy (n=7), or the aspirates were non-representative (n=6). Of these 27 patients, 13 underwent repeat FNAB because of the high suspicion of malignancy and 12 of them showed malignancy. The FNAB diagnosis of inflammatory disease of 7 patients was confirmed on subsequent surgery and 8 patients were lost to follow-up. Thus, a total of 127/142 were diagnosed to have gall bladder malignancy. Adenocarcinoma was the most common malignancy (89.76%). No procedure-related complications were encountered. CONCLUSION: US-guided FNAB is a safe and accurate technique to diagnose gall bladder malignancy. Either a repeat FNAB or surgical biopsy is recommended when the suspicion of malignancy is high and the initial FNAB is negative.     

The role of ultrasound-guided fine needle aspiration biopsy in musculoskeletal diseases

Ultrasonography (US) is a readily available non-invasive tool useful for the detection of musculoskeletal and soft tissue masses. Although X-Ray is often the first imaging study for evaluating both bone and soft tissue lesions, and magnetic resonance imaging and computed tomography are mandatory in lesions staging, US is increasingly used for the early assessment of musculoskeletal and soft-tissue masses and for guiding procedures and biopsies. Surgical biopsy or fine needle aspiration biopsy (FNAB) is needed to ascertain the nature of any lesion. FNAB is a low cost technique, safer and less traumatic than an open surgical biopsy. Significant complications are rare, mostly related to the site of biopsy. Knowledge of indications, limitations, anatomical and pathological access, adequate technical expertise in US imaging and in intervention skills are the critical factors of the appropriate and safe use of FNAB. By now, the role of FNAB in musculoskeletal diseases is controversial and there is still a heated debate in the scientific community.     

Macroscopic assessment of pulmonary fine needle aspiration biopsies: correlation with cytological diagnostic yield.

Fine needle aspiration biopsy (FNAB) is widely used in the diagnosis of pulmonary neoplasia. Previous studies have advocated the use of immediate cytological review at the time of biopsy to reduce the number of needle passes performed, whilst stating that in the absence of this, simple macroscopic assessment of sample quality was used. This latter practice is widespread, but there is no data regarding its accuracy or the level of intra-observer consistency. We assessed the degree of correlation between a macroscopic grading of the FNAB sample at the time of lung biopsy by the radiologist performing the procedure and subsequent diagnostic yield. 45 consecutive patients in whom pulmonary neoplastic disease was strongly suspected were included. Macroscopic sample appearances were graded on a five-point scale from 1 (blood with no particulate material) to 5 (solid tissue pieces). The positivity rate increased stepwise along with macroscopic grading from 50% for samples graded 1 to 100% for samples graded 5. Grouping the predominately haemorrhagic samples (graded 1-2) together and comparing them with the particulate samples (graded 3-5) demonstrates a statistically significant difference in diagnostic yield (p<0.001). This small study shows that a simple macroscopic grading of pulmonary FNAB samples can provide a good indication of likely cytological diagnostic yield and that radiologists can develop a degree of consistency in their assessment. In the absence of direct cytological input, this may provide a basis for decisions on the number of passes performed.     

Ultrasound-guided transthoracic co-axial biopsy of thoracic mass lesions

PURPOSE: To compare the diagnostic yield of fine-needle aspiration biopsy (FNAB) and cutting needle biopsy in thoracic lesions. MATERIAL AND METHODs: Thirty patients with thoracic mass lesions were subjected to ultrasound-guided co-axial FNAB and cutting needle biopsy using 0.7 mm aspirating and 1.0-mm cutting needles, respectively. The diagnostic yield of the individual modalities was compared with the combined yield. RESULTS: A conclusive diagnosis was obtained in 76.6% (n=23) of patients by FNAB and in 66.6% (n=20) by cutting needle biopsy. The combined diagnostic yield of FNAB and cutting needle biopsy was 93.3% (n=28) with a significant statistical difference (p<0.03) as compared to cutting biopsy alone. Of the patients, 23.2% (n=7) had benign and 76.6% (n=23) malignant aetiologies. The diagnostic yield of FNAB versus cutting needle biopsy in benign lesions was 57.1% (n=4) and 100% (n=7), respectively. The diagnostic yield of FNAB versus cutting needle biopsy in malignant lesions was 82.6% (n=19) and 56.5%, (n=13). Two patients remained undiagnosed by either modality. There were no complications. CONCLUSION: FNAB and cutting needle biopsy are complementary to each other and attempts should be made to obtain small tissue cores in addition to routine cytologic specimens in diagnosing thoracic lesions, especially in benign pathologies. US provides a safe guidance modality for lesions abutting the chest wall.     

MRI-guided biopsy and fine needle aspiration biopsy (FNAB) in the diagnosis of musculoskeletal lesions

Objectives

The purpose of this study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) guided musculoskeletal biopsy and the value of fine needle aspiration biopsy (FNAB) when combined with histologic biopsy.

Materials and methods

A total of 172 biopsies were performed under MRI guidance, 170 were histologic biopsies. In 112 cases, a fine needle aspiration biopsy was also performed. In two cases, a stand-alone FNAB was performed. The diagnostic performance was evaluated retrospectively by comparing the histopathologic and cytologic diagnosis with the current or final diagnosis after at least one year of clinical and imaging follow-up. A 0.23 T open MRI scanner with an interventional stereotactic guidance system was used.

Results

The overall diagnostic accuracy of MRI guided biopsy was 0.95, sensitivity 0.91, specificity 0.98, positive predictive value (ppv) 0.97 and negative predictive value (npv) 0.93. The diagnostic accuracy of trephine biopsy alone was 0.93, sensitivity 0.89, specificity 0.98, ppv 0.97 and npv 0.91 and accuracy for FNAB alone was 0.85, sensitivity 0.80, specificity 0.90, ppv 0.89 and npv 0.82.

Conclusions

MRI guidance is a feasible and accurate tool in percutaneous musculoskeletal biopsies. Fine needle biopsy is a useful low-cost supplement to histologic biopsy.     

CT引导下椎体穿刺活检的相关问题及解决办法

目的探讨脊柱疾病CT引导下穿刺活检相关问题,分析相应的解决办法,评价其安全性及临床应用价值。方法68例脊柱疾病CT引导下穿刺活检,病灶位于颈椎9例,胸椎19例,腰椎28例,骶椎12例。根据不同病变部位设计相应的穿刺路径和体位。操作过程中CT监测穿刺针走向,达预定位置后取材。结果所有病例穿刺针成功到达病灶并获得标本,技术成功率为100%,穿刺活检诊断阳性率92.6%(63/68),假阴性率7.4%(5/68)。并发症发生率5.9%(4/68)。结论CT引导下椎体穿刺活检能清楚显示穿刺针的位置及周围复杂的解剖结构,安全可靠,并发症极少,诊断正确率高,为临床制定治疗方案提供依据,值得推广。     

CT guided percutaneous fine needle biopsy of small lung lesions in outpatients. Safety and efficacy of the procedure compared to inpatients

PURPOSE: To compare the safety and efficacy of CT-guided fine needle biopsy (FNAB) of small (<15 mm) lung lesions in inpatients and outpatients. MATERIALS AND METHODS: 108 consecutive inpatients (69 M, 39 F, mean age 56) and 121 consecutive outpatients (90 M, 31 F, mean age 50) who underwent CT-guided FNAB of small lung lesions were included. Lesion size, depth, number of needle passes, presence of emphysema were recorded. 22 G Chiba needles and the roll-over technique were used for all patients; if no significant pneumothorax was detected after FNAB, outpatients were allowed to go home and instructed to return in case of complications. The incidence of pneumothorax and other complications, sensitivity, specificity, diagnostic accuracy were calculated. RESULTS: 12 inpatients and 33 outpatients were lost to follow-up. No statistical differences were observed in lesion size, depth, needle passes, presence of emphysema between the groups. We had 15 pneumothoraces in inpatients, 4 requiring a chest tube, 12 in outpatients, 2 requiring a tube. Diagnostic accuracy was 92.7% in inpatients and 90.9% in outpatients. There were 7 false negatives in inpatients and 8 in outpatients, with negative predictive value of 79% and 78%, respectively. There were no false positives. All differences are nonsignificant. CONCLUSIONS: CT-guided FNAB of small lung lesions is an equally safe and effective procedure in inpatients and outpatients; outpatient performance of FNAB can decrease costs.     

Interventional breast procedures

The capability to provide histologic diagnoses of nonpalpable lesions by performance of percutaneous needle biopsy has revolutionized breast imaging in the past decade. The radiologist who performs percutaneous breast biopsies assumes an increased level of responsibility for the patient regarding patient selection, lesion selection, performance of the biopsy procedure, interpretation of results, and patient follow-up. With variable and increasingly numerous options for the biopsy of breast lesions, careful attention must be paid to the selection of patients and types of lesions for different procedures. Critical technical considerations affect whether biopsy of a lesion can be optimally performed percutaneously, and these considerations must be factored into the recommendations for patient treatment. In addition, a limited preprocedural clinical assessment of the patient will allow a safer procedure to be performed expeditiously. Most breast abnormalities classified by using the ACR Lexicon as 4 (suggestive) or 5 (highly suggestive, likely malignant) are suitable for either percutaneous breast needle biopsy or needle localization and excisional biopsy. In general, those lesions classified as 3 (probably benign) carry a recommendation for early follow-up and not biopsy, because the likelihood of malignancy is small. A particular advantage of percutaneous biopsy is in the diagnosis of multicentric breast cancer. Core biopsy is less invasive and less costly than surgical biopsy, and it can be used to demonstrate multicentric disease, saving the patient a two-step surgery. However, several lesions are better treated by excision than by percutaneous biopsy. Among these are architectural distortion or loosely arranged, segmental or regional microcalcifications. For nonpalpable breast lesions visualized on mammography, sonography, or both, imaging-guided localization is required for precise needle placement either for wire localization or for percutaneous breast biopsy. The selection of which modality to use for guidance depends on (1) the adequacy of visualization of the lesion by the modality used, (2) the position of the lesion, (3) the ease of positioning the patient, (4) the skill of the operator, (5) the need to reduce radiation exposure, (6) the overall patient condition, and (7) size of the lesion. Fine-needle aspiration biopsy (FNAB) has a high sensitivity and specificity in the diagnosis of palpable breast lesions when the procedure is properly performed and interpreted. Variable results have been achieved with FNAB of nonpalpable breast lesions under imaging guidance. Three critical components are necessary to achieve reliable results by using FNAB. These include the following: (1) accuracy in needle placement, (2) skill in performance of FNAB, and (3) expert cytopathologic analysis. Accurate preoperative needle localization of nonpalpable breast lesions allows the radiologist to guide the surgeon performing an open biopsy and helps to ensure that the surgical procedure can be performed quickly and can be accomplished with the best possible cosmetic result for the patient. Lesions selected for needle localization and biopsy should undergo a complete tailored imaging evaluation before the needle localization is scheduled. Specimen radiography should be performed for all nonpalpable lesions. Once the lesion has been identified on specimen radiography, the radiologist can assist the pathologist in identifying the lesion microscopically by marking the lesion within the surgical specimen. We cover the technical and interpretative aspects of percutaneous breast biopsy and needle localization for surgical biopsy.     

细针吸取活检诊断各种脏器肿块158例总结

1987年7月～1990年6月,我们用细针吸取活检不同脏器肿块病人158例,其中胸腔62例,腹腔37例,体表59例。120例诊断为恶性肿瘤,其中93例明确了组织学类型(77.5%)。经活检或临床观察随访证实其准确率为95%(150/158),假阳性为0.83%(1/120),假阴性18%(7/38)。部分病例同时进行了细胞学和组织学检查,诊断的准确率较高。158例病人均未出现严重并发症。     

CT引导下经皮椎体病变穿刺活检的临床研究

目的评价CT引导下经皮椎体病变穿刺活检的成功率、诊断正确性及临床应用价值。方法85例椎体病变患者经皮穿刺活检,病变位于颈椎3例,胸椎26例,腰椎37例和骶椎19例。影像学上表现57例为溶骨性病变,19例成骨性病变,9例溶骨性与成骨性病变共存。穿刺标本行细胞学及组织学检查。临床怀疑感染性病变时行细菌学检查。对穿刺标本进行诊断的正确性分析。结果CT证实85例穿刺活检针均位于病灶内,81例取得病变组织,活检成功率95%。活检标本包括29例骨组织标本,5例软组织标本,47例骨组织与软组织混合标本,4例未取得标本;病理结果包括44例转移瘤,17例原发性骨肿瘤,18例感染性病变,2例正常椎体组织。79例诊断正确,诊断正确性97.5%。结论CT引导下经皮椎体病变穿刺活检是对椎体病变作出正确诊断的重要手段,为临床提供了可靠的组织学依据,且穿刺部位正确、三维定向好、损伤小,可以作为诊断不明确的溶骨性及溶骨与成骨混合性椎体病变拟行椎体成形术术前常规。     

Value of a new apparatus for percutaneous vertebral bone biopsy

Percutaneous vertebral trephine biopsy is a valuable investigation. A new type of trephine needle for vertebral biopsy is described in this paper. This trephine needle is introduced on the thin needle used for local anesthesia, following a procedure similar to vascular catheterism. Thus, the same puncture is used for local anesthesia and bone biopsy. Therefore, local anesthesia is more effective and the biopsy procedure is much safer, particularly at the thoracic level where vital organs are very close to the spine. A very practical handle design for advancing the trephine needle on the guide wire makes the biopsy procedure easy and precise. This trephine needle enhance indications of this potentially valuable procedure.     

Trans-thoracic biopsy of lung lesions: FNAB or CNB? Our experience and review of the literature

Purpose

This study was performed to determine the type and incidence of complications of fine-needle aspiration biopsy (FNAB) and core biopsy (CNB) performed under computed tomography (CT) guidance to characterise lung lesions, and assess the diagnostic accuracy of the two techniques.

Materials and methods

In 2009–2011, we performed 124 lung biopsies (66 CNB and 56 FNAB) on 121 patients with a mean age of 72.4 years. Exclusion criteria were pulmonary resection, pleural lesions and/or effusions, and inadequate blood-coagulation profile. All examinations were acquired after contrast-agent administration in a craniocaudal direction from the lung apex to base during a single inspiratory breath-hold, with standardised parameters. Each lesion was scanned with 13–15 slices that could be repeated whenever necessary to document the needle track and for lesion centring, by positioning a metallic marker perpendicular to the centring light to indicate the point of needle access. Unless otherwise clinically indicated, 4 h after the procedure chest radiography was performed.

Results

Age was found to be a factor influencing the complications: pneumothorax in young subjects (31 %) and parenchymal haemorrhage in the elderly (30 %), with CNB but not with FNAB. We had more complications with the right lung: 50 % of pneumothorax cases in the upper lobe with CNB and 40 % of cases of haemorrhage in the lower lobe with FNAB. The anterior approach gave rise to more complications with CNB, while the posterior approach with FNAB. CNB had more complications than FNAB for lesions ≤3.5 cm (31 vs. 18 % pneumothorax), and >3.5 cm (34 vs. 9 % haemorrhage). There was no significant correlation with lesion histology, needle calibre or number of passes (probably due to the small number of procedures done with needles other than 18 G in CNB or 22 G in FNAB or involving more than one needle pass). The diagnostic accuracy of FNAB, done with a pathologist’s extemporaneous assessment of sample adequacy, was 94.83 % against 81.82. % of CNB.

Conclusions

FNAB under CT guidance is subject to a lower rate of complications and, if performed in the presence of the pathologist, has a greater diagnostic accuracy compared to CNB.     

The use of ultrasound-guided cutting-needle biopsy in paediatric neck masses

Objective: Neck masses are common in children. Although there is a low incidence of therapeutically significant pathology, biopsy is occasionally required for evaluation. Open biopsy or fine needle aspiration may be used to obtain tissue. Open biopsy provides material suitable for histological analysis but requires general anaesthesia. Cytological material obtained by fine needle aspiration is often inconclusive. A core of histological material may also be obtained by percutaneous cutting-needle biopsy, a recognised procedure at other anatomical sites, usually performed under local anaesthesia.? Materials and Methods: There are few accounts using cutting needles in adult neck masses and no previous paediatric series. We present our experience of ultrasound-guided core biopsies of neck masses in 15 children ranging in age from three months to 16 years.? Results: Thirteen biopsies were easily performed without sedation as an outpatient procedure under topical and injected local anaesthetic. In all fifteen cases the procedure was well tolerated and a tissue successfully obtained.? Conclusion: Ultrasound guided cutting needle biopsies of head and neck masses of children can be performed under local anaesthesia in the majority of cases. Received: 2 October 1998; Revision received: 6 July 1999; Accepted: 6 July 1999     

CT透视引导下细针抽吸活检并T.B.O快速染色诊断胸部疾病的价值

目的：研究CT透视引导下细针抽吸活检结合床边T．B．O快速染色对胸部疑难疾病的诊断价值。方法：回顾分析胸部疑难疾病48例，所有病例均运用CT透视引导细针抽吸，常规进行床边T．B．O快速染色判断，并与涂片及或细胞团切片H．E染色诊断(必要时免疫细胞化学辅助诊断)、最后诊断对照分析。结果：CT导引下穿刺成功率100％。均并行床边T．B．O快速染色后标本判断。本组48例中，恶性病变42例，良性病变6例，床边T．B．O染色判断良、恶性准确率98％(47/48)，总的诊断准确率92％(44/48)。穿刺次数1—2次，无假阳性、无严重并发症发生。结论：CT透视引导下细针抽吸活检准确、安全，床边T．B．O快速染色简单易行，二者结合诊断准确率高，对胸部疑难疾病尤其是胸部小病灶或靠近大血管病灶的诊断具有重大价值。     

Ultrasonically guided percutaneous fine needle aspiration biopsy of solid masses

Fine needle aspiration biopsy is a highly accurate cytologic technique in the differentiation of benign vs. malignant disease. After careful localization with the ultrasound beam, a 22 gauge 0.6 mm needle is used to obtain four to five cell samples. Seventy percutaneous fine needle aspiration biopsies were performed nodes, subcutaneous nodules, and other retroperitoneal masses. Ninety-three percent accuracy was obtained with no complications. Studies in four patients with carcinoma of the tail of the pancreas were falsely negative for malignant cells; all four patients had desmoplastic tumors. Complications of hemorrhage, tumor seeding, infection, fistula formation, and pain encountered with other methods and using larger bore needles have not been found with the fine needle technique. It is a safe, accurate method that can be performed as an out-patient procedure.     

Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy in cavitary pulmonary lesions

Objective

CT-guided transthoracic biopsy is a well-established method in the cytologic or histologic diagnosis of pulmonary lesions. The knowledge of its diagnostic performance and complications for cavitary pulmonary lesions is limited. The purpose of this study was to determine the diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy (FNAB) in cavitary pulmonary lesions.

Materials and methods

102 consecutive patients with pulmonary cavitary lesions received CT-guided FNAB with use of an 18-gauge (n = 35) or 20-gauge (n = 67) Chiba for histology diagnosis. The sensitivity, specificity, and diagnostic accuracy of FNAB were calculated as compared with the final diagnosis. Complications associated with FNAB were observed. The diagnostic accuracy and complications were compared between patients with different lesion sizes and different cavity wall thickness.

Results

The overall sensitivity, specificity, and accuracy of FNAB were 96.3%, 98.0%, and 96.1%, respectively. The sensitivity, specificity, and diagnosis accuracy in different lesion size (<2 cm vs ≥2 cm), or different cavity wall thickness (<5 mm vs ≥5 mm) were not different (P > 0.05; 0.235). More nondiagnostic sample was found in wall thickness <5 mm lesions (P = 0.017). Associated complications included pneumothorax in 9 (8.8%) patients and alveolar hemorrhage in 14 patients (13.7%) and hemoptysis in 1 patient (1%). No different rate of complications was found with regard to lesion size, wall thickness, length of the needle path and needle size (P > 0.05).

Conclusion

CT-guided FNAB can be effectively ad safely used for patients with pulmonary cavitary lesions.     

Ultrasound guided fine needle aspiration biopsy of splenic lesions

Fine needle aspiration biopsy (FNAB) of focal splenic lesions has been infrequently utilized because of the risk of haemorrhage. This study was carried out to evaluate the safety and efficacy of ultrasound guided FNAB of splenic lesions. 35 patients with focal splenic lesions underwent FNAB under real-time ultrasound guidance using a free hand technique. Ultrasound findings were single or multiple focal hypoechoic lesions (n = 33), focal hyperechoic lesion (n = 1) and diffuse heterogeneous echotexture (n = 1). Aspirations were performed with 22 G spinal needles using either the subcostal or the intercostal approach. Definite cytological diagnosis was made in 22 patients (62.8%), including tuberculosis in 10 patients, lymphoma in seven patients, extramedullary haematopoiesis in two patients and aspergillosis, histoplasmosis and bacterial abscess in one patient each. FNAB was negative in 12 patients because the aspirates were either scanty or contained only blood. FNAB was falsely positive in one patient. Only one patient had significant intraabdominal bleeding, which was managed conservatively. In conclusion, splenic FNAB performed under ultrasound guidance is a safe and accurate method in the diagnosis of focal splenic lesions.     

Abdominal mass in childhood: characterization with fine needle percutaneous biopsy guided with computerized tomography]

INTRODUCTION: CT-guided fine needle aspiration biopsy (FNAB) is known to improve diagnosis of expansile abdominal lesions, especially relative to more invasive procedures like explorative laparotomy. FNAB is not commonly used in pediatric patients because of their poor collaboration and of associated risks. We investigated the feasibility of FNAB in the pediatric age. MATERIAL AND METHODS: Over a 2-year period, we performed CT-guided FNAB of 21 abdominal lesions in a series of pediatric patients ranging in age 10 days to 14 years. Thirteen lesions were in intraperitoneal and 8 in retroperitoneal sites. CT had been performed in all patients but had failed to make a diagnosis. Cytologic samples were obtained with 22-23 G needles; the cytologist was always present to ensure adequate sampling. Follow-up CT was performed to assess the possible onset of complications. RESULTS: First-pass diagnosis was made in 14 of 21 biopsies and second-pass diagnosis in 5; histology was needed in three cases. Cytologic findings were compared with postoperative histologic results in 13 cases; clinical follow-up and further instrumental studies confirmed the diagnosis in nonsurgical patients. CONCLUSIONS: CT-guided FNAB can be performed in pediatric patients with accuracy and confidence. These patients' age calls for great skills of the operator and possible contraindications must be accurately evaluated; complications must not be neglected. FNAB should be performed during CT examination because young patients often require anesthesia. The pathologist's presence during biopsy permits to repeat sampling, if necessary, without repeating the anesthesia. CT-guided FNAB is a valid alternative to explorative laparotomy in the workup of expansile abdominal masses also in pediatric patients.     

Combined CT-guided biopsy and cytology in diagnosis of bony lesions.

The results of 44 trephine (OD 1.4-4 mm) biopsies and 39 fine needle (0.7-0.9 mm) aspirations of skeletal, mainly vertebral, lesions performed under CT-guidance in 54 patients were evaluated. The fine needle sample was aspirated through the trephine as a complementary procedure in 29 patients and a fine needle aspiration only was performed in 10 patients. Trephine biopsy only was performed in 15 patients. Sufficient material for histologic and cytologic analyses was obtained in 93% (41/44) and 97% (38/39) and a correct benign or malignant diagnosis was obtained in 84% (37/44) and 90% (35/39), respectively. Among the combined examinations the fine needle aspiration alone was diagnostic in 2 cases while the trephine specimen alone provided diagnostic material in 2 cases. In 24 cases both the cytologic and histologic samples were adequate for diagnostic purposes. In one case both methods gave false-negative results. The combined use of cytologic and histologic samples in CT-guided bone biopsies increased diagnostic accuracy. The aorta was perforated once with a 1.4-mm needle but without sequelae. CT-guided bone biopsy was found to be a safe, reliable and cost-efficient method.     

骨骼肌肉恶性肿瘤病变CT引导下经皮穿刺活检正确性分析

目的 探讨CT导引下经皮穿刺活检对骨骼肌肉恶性肿瘤性疾病的诊断价值.方法 106例骨骼肌肉病变行CT导引下经皮穿刺活检,对比穿刺病理结果与临床诊断最终结果.结果 106例CT导引下经皮骨骼肌肉穿刺活检病例,经临床手术及切开活检病理结果全部为恶性肿瘤病变,其中89例病理结果与CT导引下经皮穿刺活枪结果相符,17例CT导引下穿刺活检病理结果为"阴性".活检正确率84.0%;结论CT导引下经皮穿刺对骨骼肌肉恶性肿瘤性病变是安全、简便、有效的诊断手段,对于活检结果为"阴性"的病例适时的切开活检可能是必要的.