Diagnostic yield in CT-guided stereotactic biopsy of gliomas.
Diagnostic yield in CT-guided stereotactic biopsy of gliomas.
复制标题
CT 引导的神经胶质瘤立体定向活检的诊断率。
DOI：
10.3171/jns.1989.71.4.0494
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发表时间：
1989
影响因子：
4.1
通讯作者：
G. Dyste
中科院分区：
文献类型：
--
作者：
G. M. Greene;P. Hitchon;Robert L. Schelper;W. T. Yuh;G. Dyste
27例患者接受了29次计算机断层扫描（CT）引导的立体定向活检手术，用于治疗未经治疗或复发的恶性星形细胞瘤。在对比增强CT扫描上，从低密度中心、增强边缘和低密度周边获得活检，诊断率（活检产生肿瘤的数量/获得的活检数量）：这三个区域分别为34/61（56%）、68/101（67%）和8/22（36%）。虽然在所有三个区域都能识别出肿瘤，但低密度中心和增强边缘的诊断率明显更高。未治疗肿瘤患者与复发肿瘤患者的比较表明，肿瘤分布无统计学差异，尽管复发肿瘤组中低密度外周的产率有较高的趋势。肿瘤被发现超过CT增强边缘15 mm，除了在T2加权磁共振图像上延伸到异常区域之外。这些结果提示，系列立体定向活检应针对低密度中心和增强边缘，以提高诊断率。从低密度周边获得的活检材料表明肿瘤也表明，在计算间质辐射剂量时，应考虑超出CT增强边缘范围的肿瘤体积。
Twenty-seven patients underwent 29 computerized tomography (CT)-guided stereotactic biopsy procedures for untreated or recurrent malignant astrocytomas. Biopsies were obtained from the hypodense center, enhancing margin, and hypodense periphery as seen on contrast-enhanced CT scans, with diagnostic yields of (number of biopsies yielding tumor/number of biopsies obtained): 34/61 (56%), 68/101 (67%), and 8/22 (36%) from these three zones, respectively. Although tumor was identified in all three zones, diagnostic yield was significantly higher in the hypodense center and enhancing margin. Comparison of patients with untreated tumors to those with recurrent tumors demonstrated no statistical difference in tumor distribution, although there was a trend toward a higher yield from the hypodense periphery in the recurrent tumor group. Tumor was found up to 15 mm beyond the CT-enhancing margin, in addition to extending beyond the area of abnormality on T2-weighted magnetic resonance images. These findings suggest that serial stereotactic biopsies should be targeted to the hypodense center and enhancing margin for improved diagnostic yield. Biopsy material obtained from the hypodense periphery that demonstrates tumor also indicates that a tumor volume beyond the confines of the CT-enhancing margin should be considered when calculating dosimetry for interstitial radiation.