Magnetic resonance imaging guided biopsy of musculoskeletal lesions
Magnetic resonance imaging guided biopsy of musculoskeletal lesions
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DOI：
10.1016/j.jcma.2012.02.008
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发表时间：
2012-04-01
影响因子：
3
通讯作者：
Chiou, Hong-Jen
中科院分区：
文献类型：
--
作者：
Wu, Hung-Ta H.;Chang, Cheng-Yen;Chiou, Hong-Jen
背景：微创介入活检术具有定位准确、切口小、恢复快等优点。本研究的目的是临床测试和评估的有效性的磁共振成像（MRI）的指导技术，获得肌肉骨骼活检使用适当的成像方式和instrument.Methods：我们使用MRI兼容活检针的活体骨活检集（Daum，德国），和1.5 T的封闭磁铁MRI扫描仪被用来执行MM引导活检。脉冲序列包括快速自旋回波T1和T2加权成像和梯度回波成像。入选标准包括存在骨或软组织肿块、感染性疾病和其他需要组织确认的非特异性病变。病变，不能可视化的计算机断层扫描（CT）或其他成像models.Results：从2005年1月至2009年12月，23例（12男11女，年龄11-82岁）进行肌肉骨骼MM引导活检。活检部位如下：脊柱（n = 12）、胫骨（n = 3）、骨盆（n = 1）、股骨（n = 2）、肩胛骨（n = 1）、肱骨（n = 1）、尺骨（n = 1）、肩胛骨（n = 1）和肩部软组织肿块（n = 1）。最终诊断包括骨转移7例，脊髓骨髓炎和脊椎炎5例，化疗后骨坏死4例，骨髓改变或良性病变3例，不全性骨折1例，长骨骨髓炎1例，软组织转移1例，神经周围腱鞘囊肿1例。在23例病例中，有10例在CT引导下几乎看不到或看不到病变。病理分析和实验室培养显示，MRI引导下穿刺活检成功率为100%（23/23）。结论：MRI引导下活检对骨髓病变、化疗或放疗后存活的肿瘤以及CT无法显示的病变的定位特别有价值。该方法准确、安全，是一种很好的替代活检方法，可作为射频消融或其他介入治疗中骨病变定位的一种很好的辅助技术。版权所有（C）2012 Elsevier Taiwan LLC及中华医学会。All rights reserved.
Background: Minimally invasive interventional biopsy procedures have the advantages of accurate localization, small incisions, and rapid recovery. The purpose of this study was to clinically test and evaluate the efficacy of the magnetic resonance imaging (MRI)-guidance techniques for obtaining musculoskeletal biopsies using the appropriate imaging modalities and instruments.Methods: We used MRI-compatible biopsy needles from the Invivo Bone Biopsy Set (Daum, Germany), and a 1.5-T closed-magnet MRI scanner was used to perform the MM-guided biopsy. The pulse sequences included fast spin echo T1- and T2-weighted imaging and gradient echo imaging. The inclusion criteria included the presence of bone or soft tissue masses, infectious disease, and other nonspecific lesions that required tissue confirmation. Lesions that could not be visualized by computed tomography (CT) or other imaging modalities were preferred.Results: From January 2005 through December 2009, 23 patients (12 males and 11 females, aged 11-82 years) underwent musculoskeletal MM-guided biopsy. The biopsy locations were as follow: spine (n = 12), tibia (n = 3), pelvis (n = I), femur (n = 2), scapula (n = 1), humerus (n = 1), ulna (n = 1), scapula (n = 1), and soft tissue mass of the shoulder (n = 1). The final diagnoses included bone metastasis (n = 7), spinal osteomyelitis and discitis (n = 5), osteonecrosis after chemotherapy (n = 4), bone marrow change or benign lesion without malignancy (n = 3), insufficiency fracture (n = 1), long bone osteomyelitis (n = 1), soft tissue metastasis (n = 1), and perineural ganglion cyst (n = I). In 10 of the 23 cases, the lesions were barely visualized or invisible on CT guidance. Pathologic analysis and laboratory culturing revealed that the lesions were successfully accessed by MRI-guided biopsy in 100% (23/23) of cases. No obvious complications developed during or after the procedures.Conclusion: Biopsy under MRI guidance is especially valuable for the localization of bone marrow lesions, viable tumors (after chemotherapy or radiation), and lesions that cannot be visualized using CT. It is both accurate and safe, is a good alternative biopsy method, and may be a good adjunctive technique for the localization of bone lesions for radiofrequency ablation or other interventional procedures. Copyright (C) 2012 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.