Frame-Based Stereotactic Biopsy of Canine Brain Masses: Technique and Clinical Results in 26 Cases.
Frame-Based Stereotactic Biopsy of Canine Brain Masses: Technique and Clinical Results in 26 Cases.
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DOI：
10.3389/fvets.2015.00020
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发表时间：
2015
影响因子：
3.2
通讯作者：
Debinski W
中科院分区：
文献类型：
--
作者：
Rossmeisl JH;Andriani RT;Cecere TE;Lahmers K;LeRoith T;Zimmerman KL;Gibo D;Debinski W
本报告描述了26只狗的孤立性前脑病变的方法学、诊断率和与基于帧的立体定向脑活检(FBSB)相关的不良事件(AE)。对接受FBSB手术的狗的医疗记录进行了审查，使用了两个专为小动物设计的立体定向头架，与计算机断层扫描(CT)和磁共振(MR)成像兼容。使用商业软件从MR和CT图像生成立体定向计划，FBSB在术中图像引导和无术中图像指导的情况下执行。对诊断效率的记录进行回顾，定义为产生特定神经病理诊断的活检的比例、与FBSB相关的AE以及发展为AE的危险因素。对19/26只在活检后没有立即进行治疗干预的犬进行了术后AE评估。活检靶点包括轴内端脑肿块(24/26)、1个轴内间脑肿块和1个鞍外旁肿块。靶区中位数为1.99 /cm~3。患者、病变或结果变量在使用的两种头架系统之间以及在术中CT引导或不使用的情况下进行的FBSB之间没有差异。FBSB的诊断率为94.6%。针头放置错误是购买非诊断性活检标本的一个重要风险因素。26只狗中有24只被诊断为神经胶质瘤，1只被诊断为脑膜瘤和肉芽肿性脑膜脑炎。27%(7/26)的犬可观察到与FBSB有直接关系的AE。活检相关的临床发病率，表现为癫痫发作和一过性神经恶化，发生在3/19(16%)的狗。病死率为5.2%(1/19只)，死亡原因为颅内出血。使用所述仪器的FBSB在提供狗前脑局灶性病变的神经病理学诊断方面相对安全和有效。
This report describes the methodology, diagnostic yield, and adverse events (AE) associated with frame-based stereotactic brain biopsies (FBSB) obtained from 26 dogs with solitary forebrain lesions. Medical records were reviewed from dogs that underwent FBSB using two stereotactic headframes designed for use in small animals and compatible with computed tomographic (CT) and magnetic resonance (MR) imaging. Stereotactic plans were generated from MR and CT images using commercial software, and FBSB performed both with (14/26) and without intraoperative image guidance. Records were reviewed for diagnostic yield, defined as the proportion of biopsies producing a specific neuropathological diagnosis, AE associated with FBSB, and risk factors for the development of AE. Postprocedural AE were evaluated in 19/26 dogs that did not proceed to a therapeutic intervention immediately following biopsy. Biopsy targets included intra-axial telencephalic masses (24/26), one intra-axial diencephalic mass, and one extra-axial parasellar mass. The median target volume was 1.99 cm3. No differences in patient, lesion, or outcome variables were observed between the two headframe systems used or between FBSB performed with or without intraoperative CT guidance. The diagnostic yield of FBSB was 94.6%. Needle placement error was a significant risk factor associated with procurement of non-diagnostic biopsy specimens. Gliomas were diagnosed in 24/26 dogs, and meningioma and granulomatous meningoencephalitis in 1 dog each. AE directly related to FBSB were observed in a total of 7/26 (27%) of dogs. Biopsy-associated clinical morbidity, manifesting as seizures and transient neurological deterioration, occurred in 3/19 (16%) of dogs. The case fatality rate was 5.2% (1/19 dogs), with death attributable to intracranial hemorrhage. FBSB using the described apparatus was relatively safe and effective at providing neuropathological diagnoses in dogs with focal forebrain lesions.