• 四川大學(xué)華西醫(yī)院腫瘤中心（成都，610041）;

【摘要】　目的　 探討CT引導(dǎo)下經(jīng)椎弓根穿刺活檢對椎體病變的診斷價值及可行性。　方法　 回顧性分析2009年5月—2010年4月42例椎體病變患者經(jīng)椎弓根穿刺活檢的穿刺活檢方法、病理結(jié)果、最終診斷及穿刺并發(fā)癥。　結(jié)果　 患者總穿刺準(zhǔn)確率為95.2%（40/42）。其中惡性病變的穿刺準(zhǔn)確率為94.3%（33/35），良性病變穿刺準(zhǔn)確率為100%（7/7）；所有患者均未發(fā)生嚴(yán)重穿刺并發(fā)癥。　結(jié)論　 CT引導(dǎo)下經(jīng)椎弓根穿刺活檢診斷椎體病變有安全可靠、準(zhǔn)確性高等特點(diǎn)。
【Abstract】　Objective　 To explore the value and the feasibility of CT guided transpedicular biopsy in diagnosing vertebral body lesions. 　Methods　 From May 2009 to April 2010, 42 patients with vertebral body lesions underwent CT guided transpedicular biopsy. The clinical data including the puncture method, pahtological resutls, final diagnosis, and the pucture complications were retrospectively analyzed. 　Results　 The total accuracy rate of the puncture was 95.2%(40/42). The accuracy rate of the puncture was 94.3% (33/35) for malignant lesions and 100.0% (7/7) for benign lesions. No complication occurred. 　Conclusion　 CT guided transpedicular biopsy is very helpful in diagnosing vertebral body lesions with high accuracy and fewer complications.

引用本文： 游昕,劉霞,李俊,廖正銀. CT引導(dǎo)下經(jīng)椎弓根椎體病變穿刺活檢術(shù). 華西醫(yī)學(xué), 2011, 26(5): 688-690. doi: 復(fù)制

1. 　Ashizaira R, Ohtsuka K, Kamimura M, et al. Percutaneous transpedicular biopsy of thoracic and lumbar vertebral method and diagnostic validity[J]. Surg Neurol, 1999, 52(6): 545-551.
2. 　Ward JC, Jeanneret B, Oehlschlegel C, et al. The value of percutaneous transpedicular vertebral bone biopsies for histologic examination[J]. Spine (Phila Pa 1976), 1996, 21(21): 2484-2490.
3. 　葛坤元, 倪才方, 陳瓏, 等. 同軸活檢術(shù)在經(jīng)皮椎體成形術(shù)中的應(yīng)用[J]. 蘇州大學(xué)學(xué)報(醫(yī)學(xué)版), 2010, 30(2): 56-57.
4. 　汪和平, 向軍益, 齊晨暉, 等. 在X線、CT導(dǎo)引下經(jīng)皮椎弓根穿刺胸腰椎椎體活檢術(shù)的價值[J]. 臨床放射學(xué)雜志, 2009, 28(7): 121-122.
5. 　Lanedo JD, Ballaiche L, Haiaze B, et al. Current status of musculoskeletal interventional radiology[J]. Radiol Clin North Am, 1994, 32(2): 377-379.
6. 　朱結(jié)輝, 黃學(xué)全, 陳偉, 等. CT引導(dǎo)下經(jīng)椎弓根穿刺活檢對椎體病變的診斷價值[J]. 醫(yī)學(xué)影像學(xué)雜志, 2005, 15(1): 1-3.
7. 　李建民, 楊志平, 馬祥興. CT引導(dǎo)下經(jīng)皮經(jīng)椎弓根脊椎腫瘤穿刺活檢[J]. 山東醫(yī)科大學(xué)學(xué)報, 2000, 38(3): 293-294.
8. 　Renfrew DL, Whitten CG, Wiese JA, et al. CT guided percutaneous transpedicular biopsy of the spine[J]. Radiology, 1991, 180(2): 574-576.
9. 　Jelmek JS, Kransdorf MJ, Gray R, et al. Percutaneous transpedicular biopsy of vertebral body lesions[J]. Spine (Phila Pa 1976), 1996, 21(17): 2035-2040.
10. 　祝婷婷, 甘萬崇, 胡紅耀, 等. CT導(dǎo)向經(jīng)皮穿刺椎體活檢術(shù)在椎體病變中的診斷價值[J]. 臨床放射學(xué)雜志, 2010, 29(3): 212-213.
11. 　張雪哲, 劉輝, 陸立. CT導(dǎo)引下椎體穿刺活檢[J]. 中華放射學(xué)雜志, 1997, 31(6): 372-374.
12. 　Nourbakhsh A, Grady JJ, Garges KJ. Percutaneous spine biopsy: a meta-analysis[J]. J Bone Joint Surg Am, 2008, 90(8): 1722-1725.
  1. 1. 　Ashizaira R, Ohtsuka K, Kamimura M, et al. Percutaneous transpedicular biopsy of thoracic and lumbar vertebral method and diagnostic validity[J]. Surg Neurol, 1999, 52(6): 545-551.
  2. 2. 　Ward JC, Jeanneret B, Oehlschlegel C, et al. The value of percutaneous transpedicular vertebral bone biopsies for histologic examination[J]. Spine (Phila Pa 1976), 1996, 21(21): 2484-2490.
  3. 3. 　葛坤元, 倪才方, 陳瓏, 等. 同軸活檢術(shù)在經(jīng)皮椎體成形術(shù)中的應(yīng)用[J]. 蘇州大學(xué)學(xué)報(醫(yī)學(xué)版), 2010, 30(2): 56-57.
  4. 4. 　汪和平, 向軍益, 齊晨暉, 等. 在X線、CT導(dǎo)引下經(jīng)皮椎弓根穿刺胸腰椎椎體活檢術(shù)的價值[J]. 臨床放射學(xué)雜志, 2009, 28(7): 121-122.
  5. 5. 　Lanedo JD, Ballaiche L, Haiaze B, et al. Current status of musculoskeletal interventional radiology[J]. Radiol Clin North Am, 1994, 32(2): 377-379.
  6. 6. 　朱結(jié)輝, 黃學(xué)全, 陳偉, 等. CT引導(dǎo)下經(jīng)椎弓根穿刺活檢對椎體病變的診斷價值[J]. 醫(yī)學(xué)影像學(xué)雜志, 2005, 15(1): 1-3.
  7. 7. 　李建民, 楊志平, 馬祥興. CT引導(dǎo)下經(jīng)皮經(jīng)椎弓根脊椎腫瘤穿刺活檢[J]. 山東醫(yī)科大學(xué)學(xué)報, 2000, 38(3): 293-294.
  8. 8. 　Renfrew DL, Whitten CG, Wiese JA, et al. CT guided percutaneous transpedicular biopsy of the spine[J]. Radiology, 1991, 180(2): 574-576.
  9. 9. 　Jelmek JS, Kransdorf MJ, Gray R, et al. Percutaneous transpedicular biopsy of vertebral body lesions[J]. Spine (Phila Pa 1976), 1996, 21(17): 2035-2040.
  10. 10. 　祝婷婷, 甘萬崇, 胡紅耀, 等. CT導(dǎo)向經(jīng)皮穿刺椎體活檢術(shù)在椎體病變中的診斷價值[J]. 臨床放射學(xué)雜志, 2010, 29(3): 212-213.
  11. 11. 　張雪哲, 劉輝, 陸立. CT導(dǎo)引下椎體穿刺活檢[J]. 中華放射學(xué)雜志, 1997, 31(6): 372-374.
  12. 12. 　Nourbakhsh A, Grady JJ, Garges KJ. Percutaneous spine biopsy: a meta-analysis[J]. J Bone Joint Surg Am, 2008, 90(8): 1722-1725.