脳腫瘍のCT-guided stereotaxic biopsy104例の経験

CT-Guided Stereotaxic Biopsy in 104 Cases of Brain Tumors

I．はじめに

　CT-guided stereotaxic systemの登場により，CTで描出されるものであれば，脳内のほぼどの部位に存在するものでも，これに正確にアプローチすることが可能となった^5-7）．

　われわれはこれまでの約4年間に104例の脳腫瘍が疑われた症例に対してCT-guided stereotaxic systemを用いてneedle biopsyを行ってきた．needle biopsyは本来sampling methodであり，viable tumor cellsが均等に分布している場合には最適の方法であるが，不均一な腫瘍に対してbiopsyを試みる場合にはかなり問題がある．しかし，この点を十分に認識した上で行うのであれば，本法の正確性，低侵襲性は非常に有用であると考えられたので報告する．

Biopsy of suspected brain tumor was performed on 104 cases using Leksell's CT-guided stereotaxic system. The entire operation was performed in the CT room.

A Backlund's spiral biopsy needle was advanced to the target point in a stepwise fashion and two to nine tissue samples were obtained from one to three biopsy tracks.

Tissue sampling was impossible in two cases because the tumors were too hard for biopsy needle to advance. Also, sampling was sometimes difficult in the case of soft and necrotic tumor, cystic tumor, already treated (irradiated) tumor and the lesion including old blood clot.