Trans-sternal Percutaneous Computed Tomography Guided Core Biopsy for Anterior Mediastinal Mass: A Case Report

穿胸骨電腦斷層導引切片術於前縱膈腫瘤之應用：病例報告

蔡昇亨(Sheng-Heng Tsai) ； 蔡依橙(I-Chen Tsai) ； 陳明至(Min-Chi Chen) ； 林保鐘(Pao-Chun Lin) ； 蔡瑋琳(Wei-Lin Tsai) ； 陳詩華(Si-Wa Chan) ； 陳啟昌(Clayton Chi-Chang Chen)

《中華放射線醫學雜誌》 34卷4期 (2009/12) Pp. 277-282

摘要

使用穿胸骨電腦斷層導引經皮切片術來取得前縱膈腫瘤的組織是一個困難的技術，在國外的幾篇報告中曾提及其可行性。我們將報告一位57歲男性病人，意外發現有一個38毫米的前縱膈腔腫瘤。因為取得切片的路徑被胸骨及主動脈弓的分支所阻擋，因此我們選擇穿胸骨的路徑來做切片。我們成功的取得腫瘤組織而且沒有任何併發症產生。本文中我們將把相關影像、穿刺前的計畫與穿刺的技術與大家分享。經由這份報告我們也印證了穿胸骨電腦斷層導引切片術在台灣患者族群的可行性。

並列摘要

Trans-sternal percutaneous computed tomography (CT) guided biopsy for mediastinal mass is a difficult but feasible procedure. In the literature there have only been reports from four medical centers in western countries. Herein we report a case of 57-year-old man with a 38mm-sized mass in anterior mediastinum. Since the tumor access was blocked by both sternum and aortic arch branches, trans-sternal percutaneous CT-guided biopsy was the only possible way for tissue proof. The planning, imaging, and technique considerations of this procedure are discussed. With this particular case, we confirmed the feasibility of trans-sternal percutaneous CT-guided core biopsy in the Taiwanese population.