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Vol. 10. Issue 1.
Pages 67-74 (January 1999)
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Vol. 10. Issue 1.
Pages 67-74 (January 1999)
Biopsia manual guiada con TAC: un método sencillo, eficaz y seguro de diagnóstico de los procesos expansivos intracraneales
Freehand CT-guided biopsy: an easy, effective, and safe method for diagnosis in intracranial mass lesions
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V. Joanes, V. Martínez-Sanjuan, J. Barberá
Servicio de Neurocirugía. Hospital General Universitario de Valencia. Valencia
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Resumen
Objetivos

Se presenta nuestra experiencia con la biopsia manual dirigida con TAC en una serie consecutiva de 78 pacientes con procesos expansivos intracraneales.

Material y métodos

Los pacientes biopsiados reunían 3 criterios: 1) Presencia de un proceso expansivo intracraneal visible en la TAC y no susceptible de craneotomía de entrada; 2) localización lobar de la lesión; y, 3) tamaño de la lesión superior a 2cm. Previo a la biopsia, se obtenía una TAC y se planificaba la vía de acceso y la localización de la trepanación, que se realizaba posteriormente en quirófano con anestesia local. En la unidad de la TAC se realizaba la biopsia cerebral con una aguja especial de biopsia siguiendo ésta el trayecto cerebral pre-establecido.

Resultados

En todos los pacientes se consiguió muestra de tejido. En 74 de los 78 pacientes (94,9%) se obtuvo el diagnóstico histológico. Las histologías obtenidas fueron muy variadas con 58 pacientes con procesos tumorales y 16 con procesos no tumorales. Las complicaciones fueron: Infección de la herida en 1 caso y crisis comicial en otro. La mortalidad del procedimiento fue nula.

Conclusiones

Se concluye que, con el protocolo de selección descrito, la biopsia manual guiada con TAC es una técnica efectiva y segura, además de sencilla, rápida y económica, para obtener muestras de tejido para el diagnóstico histológico de los procesos intracraneales.

Palabras clave:
Tumor cerebral
Biopsia cerebral
Tomografía axial computarizada
Summary
Objectives

Our experience with the freehand CT-guided biopsy on a serie of 78 consecutive patients with intracranial mass lesions are presented.

Material and method

Selected patients met three criteria: 1) Presence of an intracranial mass lesion visualized by CT but in which the craniotomy is not the first therapeutic option; 2) lobar localization of the lesion; and 3) size of lesion more than 2cm. Before the biopsy a CT scan is obtained and the cerebral route and the site of trepanation are planned. A burr-hole is performed in the operating room under local anesthesia. Biopsy is performed with a special needle through the planned route in the CT suite.

Results

Tissue samples were obtained in all cases. Histological diagnosis was established in 74 of the 78 patients (94,9%). Tumoral process were identified in 58 patients and nontumoral abnormalities in 16 patients. Complications were a scalp infection in 1 patient and seizures in another patient. Postoperative mortality was nil.

Conclusions

The conclusion is that, with the protocol described, freehand CT-guided biopsy is an effective, safe easy, quick and low cost technique, to obtain tissue samples for the histological diagnosis of intracranial processes.

Key words:
Bran tumor
Cerebral biopsy
Computerized tomography

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