Biópsia estereotáxica guiada por imagem nas lesões do sistema nervoso central

Abstract

In a series of 44 image guided stereotactic biopsy from August 1995 until March 1997, findings were as follows (frequency order). Tumors, glioblastoma was the most frequent. Primary lymphoma and other conditions associated to AIDS. Metastasis, three cases, Vasculites, two cases, Arachnoid cyst, Creutzfeldt-Jakob, cortical degeneration, inespecific calcification (one case each). The age varied from 1 to 83 years. Forty one lesions were supratentorial, two infratentorial, and one was outside the brain (dura and skull) and we used stereotaxy to localize it. There was no mortality and morbidity was 2.3%. The literature is reviewed. We conclude that this procedure is safe and highly diagnostic.

Abordagem estereotáxica guiada por imagem de lesões do sistema nervoso central: precisão diagnóstica, morbidade, mortalidade

“…Em relação a este último fator Chappell e col. em 1992 estudando 25 pacientes com AIDS submetidos a biópsia estereotáxica guiada por TC observaram que nas lesões que não realçavam após contraste venoso o índice diagnóstico foi de apenas 67% e o resultado da biópsia não influenciou o tratamento. A presença do patologista na sala é de fundamental importância e parece ser fator decisivo na precisão diagnóstica 12 .…”

“…Atualmente a biópsia estereotáxica guiada por imagem é um método amplamente utilizado com índices de morbidade de 0 a 6,5% 1,[7][8][9][10][11][12][13][14] , mortalidade 0 a 9% 1,9,12,13,15-17 e acurácia de 88% a 100% 1,9,[11][12][13]16 . Analisamos a experiência de nosso Serviço.…”

Cerebral biopsy: comparison between frame-based stereotaxy and neuronavigation in an oncology center

“…On the other hand, frame-based stereotactic biopsy was the gold standard for acquiring intracranial samples for a long time [13][14][15] . The morbidity rate associated to frameless stereotaxy is 0 to 27% 13,16,17 , mortality rate ranges from 0 to 9% 18 , and the diagnostic yielding is 79 to 100% 16,19 . With the advent of neuronavigation the use of framebased biopsy is becoming smaller because image guided biopsies offers many advantages, like: (1) more comfort to the patient without the using of the stereotactic frame 20 ; (2) good diagnostic yielding and few complications 11,21 ; (3) the surgical instruments used on neuronavigation occupies less place related to the stereotactic frame applied to the patient head 22 ; (4) the trajectory of the biopsy needle can be changed any time during the surgery without new calculations 23,24 ; (5) quicker surgical times 23 .…”