Diagnostic Accuracy of Percutaneous Needle Biopsy of Vertebral Lesions / 대한척추외과학회지

STUDY DESIGN: This retrospective study is to confirm the diagnostic accuracy of percutaneous needle biopsy of vertebral lesions. OBJECTIVES: To evaluate the diagnostic accuracy of percutaneous needle biopsy and the clinical and pathological correlation of vertebral lesions. SUMMARY OF LITERATURE REVIEW: A review of previous articles showed that the diagnostic accuracy of percutaneous needle biopsy of vertebral lesions was between 77-94%. The greatest accuracy was achieved in diagnosis of metastatic disease or infection. MATERIALS AND METHODS: We performed 22 percutaneous needle biopsies in twenty vertebral bodies and two posterior elements under the CT guidance. All biopsies were performed with a 16-gauge Osty-cut bone biopsy needle. There were 1 cervical, 8 thoracic and 13 lumbar biopsies. Transpedicular approach was performed on 13 patients and paraspinal approach on 7 patients. There were 8 malignancies, 9 infections, 2 benign tumors, 2 compression fractures and 1 butterfly vertebra. RESULTS: An accurate diagnosis was made in 18 cases(81.8%) of all cases. Two of the 22 specimens were blood clots and two specimens of tuberculous spondylitis were insufficient for definite diagnosis. Bacteriological studies revealed a causative agent in 43% of pyogenic spondylitis. Histologic diagnosis confirming the clinical suspicion was obtained in 16(80%) of the 20 positive cases. There was no complication. CONCLUSION: Percutaneous needle biopsy under the CT guidance is a safe and accurate method for obtaining a diagnosis of vertebral lesions such as osteolytic lesion and infection.

Differential Diagnosis of Vertebral Lesion by Magnetic Resonance Imaging / 대한정형외과학회잡지

Differential diagnosis of vertebral lesion by simple radiography is not so easy whether the lesion is benign or malignant. The purpose of this study is to evaluate that the magnetic resonance imaging characteristics can differentiate benign or malignant vertebral lesions. In this study, thirty-nine cases of signal change within the vertebral body by MRI was reviewed retrospectively and the followings are the summary of the results. It is difficult to differenciate benign or malignant lesions, only based on MRI signal changes or vertebral lesion patterns. But those cases of pedicle involvement, complete replacement of bone marrow in T1image and associated soft tissue mass or cord compression are strongly suggest the possibility of malignancy and need further study.