Bilgisayarlı Tomografi Kılavuzluğunda Perkütan Pelvik Kemik Biyopsisi: Teknik Başarı, Tanısal Performans ve Güvenilirlik

Öz

Amaç: BT kılavuzluğunda gerçekleştirilen pelvik kemik biyopsilerinin teknik başarısını, tanısal performansını ve komplikasyonlarını değerlendirmek. Gereç ve Yöntem: 2017–2024 yılları arasında BT eşliğinde pelvik kemik (sakrum, ilium, iskium, pubis, femur proksimali) biyopsisi yapılan 50 hasta (32 kadın, 18 erkek; yaş ortalaması 57,5 ± 15,5; aralık 20–91) çalışmaya dahil edildi. Biyopsiler, en az 5 yıl deneyimli girişimsel radyologlar tarafından gerçekleştirildi. Lezyon boyutu, lokasyonu, tipi (litik, sklerotik, mikst), patoloji sonuçları, teknik başarı, tanısal performans ve komplikasyonlar hasta dosyalarından ve Picture Archiving and Communication System (PACS) üzerinden kaydedildi. Komplikasyonlar, Society of Interventional Radiology (SIR) rehberine göre minör veya majör olarak sınıflandırıldı. Bulgular: Teknik başarı %100 (50/50) idi. Patoloji sonuçları 25 (%50) malign, 15 (%30) benign ve 10 (%20) nondiagnostik olarak raporlandı; tanısal performans %80 olarak hesaplandı. Nondiagnostik lezyonlar, malign (p=0,002) ve benign (p<0,001) lezyonlara kıyasla anlamlı derecede daha küçüktü. Lezyonların 16’sı litik (%32), 17’si sklerotik (%34) ve 17’si mikst (%34) tipteydi. Lezyon tipi ile tanısal sonuçlar (diagnostik vs. nondiagnostik) arasında anlamlı ilişki saptandı (p=0,025); nondiagnostik lezyonların %70’i sklerotikti. İki hastada ağrı, bir hastada geçici hipotansiyon, bir hastada cilt altı ekimoz ve bir hastada kendini sınırlayan iliopsoas hematomu olmak üzere toplam beş (%10) hastada minör komplikasyon izlenmiş olup, hiçbir hastada majör komplikasyon gelişmedi. Sonuç: BT eşliğinde pelvik kemik biyopsisi, yüksek teknik başarı ve tanısal performans ile güvenli bir yöntemdir. Küçük ve sklerotik lezyonlarda nondiagnostik sonuç olasılığı daha yüksektir.

Anahtar Kelimeler

• Çok Kesitli Bilgisayarlı Tomografi
• Görüntüleme Eşliğinde Biyopsi
• Komplikasyonlar

Computed Tomography-guided Percutaneous Pelvic Bone Biopsy: Technical Success, Diagnostic Performance, and Safety

Öz

Objective: To evaluate the technical success, diagnostic performance, and complications of CT-guided pelvic bone biopsies. Material and Method: Fifty patients (32 women, 18 men; mean age: 57.5 ± 15.5 years; range: 20–91) who underwent CT-guided pelvic bone biopsy (sacrum, ilium, ischium, pubis, proximal femur) between 2017 and 2024 were included. Biopsies were performed by interventional radiologists with a minimum of five years of experience. Lesion size, location, type (lytic, sclerotic, or mixed), pathology results, technical success, diagnostic performance, and complications were recorded from patient files and the Picture Archiving and Communication System (PACS). Complications were classified as minor or major according to the Society of Interventional Radiology (SIR) guidelines. Results: Technical success was 100% (50/50). Pathology revealed malignancy in 25 (50%) patients, benignity in 15 (30%), and nondiagnostic results in 10 (20%), yielding a diagnostic performance of 80%. Nondiagnostic lesions were significantly smaller than malignant (p=0.002) and benign (p<0.001) ones. Lesion types were lytic in 16 (32%), sclerotic in 17 (34%), and mixed in 17 (34%) cases. When pathology results were grouped as diagnostic (malignant or benign) vs. nondiagnostic, a significant association was found with lesion type (p=0.025); 70% of nondiagnostic lesions were sclerotic. Minor complications occurred in 5 (10%) patients, including moderate pain (n=2), transient hypotension (n=1), ecchymosis (n=1), and localized iliopsoas hematoma (n=1). No major complications were observed. Conclusion: CT-guided pelvic bone biopsy is a safe procedure with high technical success and diagnostic yield. Smaller and sclerotic lesions are more likely to result in nondiagnostic outcomes.

Anahtar Kelimeler

• Complication
• Image-Guided Biopsy
• Multidetector Computed Tomography

Kaynakça

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