立体定向脑病变活检术

目的：探讨立体定向脑病变活检术的手术技巧及影响因素。方法：总结20例立体定向活检病例，其中多发病灶者4例，单发病灶者16例。使用CT、MRI扫描、立体定向仪及手术计划系统精确定位靶点、制定合适的活检轨迹。使用Backlund和Sedan活检针取材，脑浅表病灶使用立体定向环钻开颅全切。术中冰冻活检，术后石蜡包埋病理检查和免疫组化检查。结果：19例获明确的病理诊断，活检阳性率95％。其中，9例脑胶质瘤，3例海绵状血管瘤、2例脑转移瘤，3例非特异性炎性肉芽肿，1例结核性肉芽肿，1例脑弓形虫病。结论：立体定向脑病变活检术是神经外科十分重要的安全的诊治手段。

Stereotactic Biopsy of Brain Lesions

Objective： To evaluate the safety and accuracy of minimally invasive stereotaetic biopsy of the brain, explore the operation method and technical note. Methods： ： 20 cases with brain lesions receiving minimally invasive stereotactic biopsy surgery were retrospectively analyzed. Of them, 5 patients underwent the stereotaetic biopsies guided by CT and by usingASA-602 stereotactic system, while the other 15 patients guided by MR and by using Leksell stereotactic system. Single sampling biopsies through one biopsy trajectory were performed in 16 patients and via multiple biopsy needle tracks in 4. Results： Brain tumors were diagnosed pathologically in ~11 patients, inflammatory brain lesions in 4, cavernous angioma in 3 and parasitic disease in 1, Altogether19（95 %）patients were diagnosed pathologically by brain biopsy. In the other lpatients, biopsy failed to make pathological diagnosis since no specific changes were found. Complications related to biopsy surgery occurred in no patient and no patient died. Conclusion： The result suggests that the minimally invasive stereotactic biopsy represents a safe and reliable method for pathological diagnosis of brain lesions with low potential risk of complications.