Biópsia percutânea de lesões ósseas guiada por tomografia computadorizada: taxas de definição diagnóstica e complicações

Abstract

ObjectiveTo determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy.Materials and MethodsRetrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results.ResultsMost patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paresthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011).ConclusionCT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions.

Minimally invasive biopsy of bone tumors: technical aspects

“…По данным литературы [1][2][3][4][5][6][7][8][9][10][11][12], взятие биопсии патологических образований кости с помощью игл разного диаметра позволяет с высокой вероятностью получить материал для установки предоперационного диагноза -81,5-100%, имеет ряд преимуществ перед открытой биопсией: меньше риск осложнений -0-1,1% против 16% при открытой биопсии, существенно ниже стоимость, меньшее количество койко-дней, возможность выполнения в условиях стационара одного дня.…”

“…В настоящее время достаточное распространение получила альтернативная, малоинвазивная методика забора биопсийного материала -трепанобиопсия (толстоигольная биопсия) под КТ-и МРТ-наведением. Эта процедура, по мнению ряда авторов [1][2][3][4][5][6][7][8][9][10][11][12], имеет сравнимую с открытой биопсией эффективность получения достаточного количества опухолевой ткани (81,5-100%), меньший риск развития осложнений и более высокую экономическую составляющую. Кроме того, есть данные об отсутствии существенных преимуществ у открытой биопсии в качестве уточняющей методики.…”

Ivory vertebra: imaging findings in different diagnoses

“…Using imaging methods to evaluate the musculoskeletal system is a current theme in the recent radiology literature from Brazil ( 1 - 8 ) . In general, radiography is the first step in imaging investigation of backbone diseases, followed by computed tomography (CT) or magnetic resonance imaging (MRI).…”

Computed tomography-guided percutaneous trephine removal of the nidus in osteoid osteoma patients: experience of a single center in Brazil

“…In the past, open surgery was performed and the nidus had to be removed with a bone block, but is often unsuccessful because the nidus is difficult to find and remove completely ( 8 ) . CT-guided percutaneous biopsy of bone lesions as a diagnostic tool has shown to be accurate and safe ( 9 - 11 ) . In order to achieve removal or destruction of the nidus several CT-guided percutaneous techniques was developed.…”