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
V. Joanes, V. Martínez-Sanjuan, J. Barberá
Servicio de Neurocirugía. Hospital General Universitario de Valencia. Valencia
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Martínez-Sanjuan, J. Barberá" "autores" => array:3 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Joanes" ] 1 => array:2 [ "nombre" => "V." "apellidos" => "Martínez-Sanjuan" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Barberá" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital General Universitario de Valencia. Valencia" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Freehand CT-guided biopsy: an easy, effective, and safe method for diagnosis in intracranial mass lesions" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec156612" "palabras" => array:3 [ 0 => "Tumor cerebral" 1 => "Biopsia cerebral" 2 => "Tomografía axial computarizada" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec156611" "palabras" => array:3 [ 0 => "Bran tumor" 1 => "Cerebral biopsy" 2 => "Computerized tomography" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se presenta nuestra experiencia con la biopsia manual dirigida con TAC en una serie consecutiva de 78 pacientes con procesos expansivos intracraneales.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">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 2<span class="elsevierStyleHsp" style=""></span>cm. 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.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Our experience with the freehand CT-guided biopsy on a serie of 78 consecutive patients with intracranial mass lesions are presented.</p> <span class="elsevierStyleSectionTitle">Material and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">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 2<span class="elsevierStyleHsp" style=""></span>cm. 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.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Joanes, V.; Martínez-Sanjuán, V.; Barberá, J.: Biopsia manual con TAC: un método sencillo, eficaz y seguro de diagnóstico de los procesos expansivos intracraneales. Neurocirugía 1999; 10: 67–74.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| 2013 Julio | 23 | 26 | 49 |
| 2013 Junio | 19 | 35 | 54 |
| 2013 Mayo | 20 | 42 | 62 |
| 2013 Abril | 13 | 32 | 45 |
| 2013 Marzo | 11 | 34 | 45 |
| 2013 Febrero | 13 | 26 | 39 |
| 2013 Enero | 10 | 23 | 33 |
| 2012 Diciembre | 9 | 16 | 25 |
| 2012 Noviembre | 1 | 6 | 7 |
| 2012 Octubre | 0 | 3 | 3 |
| 2012 Septiembre | 0 | 1 | 1 |
| 2012 Enero | 9 | 0 | 9 |
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