Correlation of diagnostic yield of stereotactic brain biopsy with number of biopsy bits and site of the lesion
Correlation of diagnostic yield of stereotactic brain biopsy with number of biopsy bits and site of the lesion
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DOI：
10.1007/s10014-006-0204-y
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发表时间：
2006-01-01
影响因子：
3.3
通讯作者：
Mahapatra, A. K.
中科院分区：
文献类型：
--
作者：
Jain, Deepali;Sharma, Mehar Chand;Mahapatra, A. K.
我们的目的是检查组织学诊断的可靠性，并与沿着立体定向针的单个轨迹获得的活检点的数量进行比较。对1995-2005年间在一个三级护理神经科学中心进行的立体定向活检进行了回顾性分析。组织病理学的总体诊断准确率与立体定向活检获得的位数相关。共分析86例，其中男性58例，女性28例。年龄6~75岁，平均36.1岁。20%的患者在儿科年龄组，1.5%的患者年龄=60岁。最常见的活检部位是丘脑/基底节(55.8%)，其次是口才部位和其他部位。组织学确诊70例(诊断率81.3%)，包括65个肿瘤性病变和5个非肿瘤性病变。最常见的星形细胞病变包括毛细胞性星形细胞瘤(PA)10例，弥漫性星形细胞瘤(DA)29例，间变性星形细胞瘤(AA)11例，多形性胶质母细胞瘤(GBM)7例。16例无法提供明确的组织学诊断。活组织检查的数量从1到6比特(平均2例，中位数1例)不等。大多数(68.7%)活检标本为1或2位。诊断准确率由单次活检的76.5%提高到2位和3位的84%和88.2%，对5~6位的诊断准确率为100%。总体而言，与单一活检相比，活检更多的病例有更高的诊断率的趋势。因此，这个小系列证实了涉及多个比特的立体定向手术与高诊断率相关。
Our objective was to examine the reliability of histological diagnosis achieved vis a vis the number of biopsy bits obtained along a single trajectory of the stereotactic needle. A retrospective analysis of stereotactic biopsies performed in a single tertiary care neurosciences center, during a period of 11 years, between 1995 to 2005 was done. The overall diagnostic accuracy achieved on histopathology was correlated with the number of bits obtained by stereotactic biopsy. A total of 86 cases were analyzed, which consisted of 58 males and 28 females. Age ranged from 6 to 75 years, with a mean age of 36.1 years. Twenty percent of the patients were in the pediatric age group and 1.5% were >= 60 years of age. Most common sites biopsied were thalamus/basal ganglia (55.8%), followed by eloquent areas and other sites. A definitive histological diagnosis was established in 70 cases (diagnostic yield, 81.3%), which encompassed 65 neoplastic and 5 nonneoplastic lesions. Astrocytic lesions, the most common, include 10 pilocytic astrocytomas (PA), 29 diffuse astrocytomas (DA), 11 anaplastic astrocytomas (AA), and 7 glioblastoma multiforme (GBM). In 16 cases no definite histological diagnosis could be offered. The number of biopsies ranged between 1 and 6 bits (mean, 2; median, 1). The majority (68.7%) of the biopsies were 1 or 2-bits. The diagnostic accuracy increased from 76.5% for single biopsies to 84% and 88.2% for 2 and 3 bits, respectively, and 100% for biopsies with 5 to 6 bits. Overall, a trend of higher diagnostic yield was seen in cases with more biopsies when compared with single bit biopsies. Thus, this small series confirms that stereotactic procedures involving multiple bits are associated with a high diagnostic yield.