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The article is professionally consulted by MSc, BS. Dang Manh Cuong - Radiologist - Radiology Department - Vinmec Central Park International General Hospital. The doctor has over 18 years of experience in the field of ultrasound - diagnostic imaging.Bone biopsy under computed tomography is the most commonly used technique today. This method has many advantages such as minimally invasive, small puncture, safe, high accuracy and does not cause radiation contamination for medical staff.
1. In what cases is the technique of bone biopsy under computed tomography indicated?
A bone biopsy is a procedure in which a needle is inserted through the skin and directly into the bone to remove a small sample of bone from the body. The patient sample will be viewed under a microscope to detect diseases such as cancer, infection,... Bone biopsy results will provide a lot of important information, helping the doctor decide on the treatment method for the patient. patient.Bone biopsy is indicated for bone lesions that need to confirm the diagnosis, suspected tumor lesions, inflammation, tuberculosis,... There are two methods of biopsy to get specimens that are:
Open biopsy to take Specimen: Make an incision through the skin to expose the area of bone. The patient will be given general anesthesia or medication to prevent pain in the area where the surgery is performed. X-ray or computed tomography-guided needle biopsy: local anesthetic is used, then the needle is inserted through the skin and directly into the bone. In which, bone biopsy under computerized tomography is a modern technique with many advantages such as minimally invasive, high accuracy, small needle puncture, no radiation contamination for medical staff.
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2. Pre-preparation for bone biopsy under computed tomography
2.1. Executor
The implementation team includes specialists, auxiliary doctors, technicians, and nurses. If the patient is too excited, unable to cooperate, more support from the doctor or anesthesiologist is needed.2.2. Necessary means
Computer tomography machine ; film printer, film, image storage system Anesthesia, anesthetic (if indicated), antiseptic, water-soluble iodinated contrast agent; specialized biopsy needles; needles; cotton, gauze, ...
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2.3. Prepare patient before bone biopsy under computed tomography
To prepare for the biopsy, the patient will be thoroughly explained by the medical staff about the procedure, steps, and possible complications. Bone biopsy is done only after the patient or family member signs a consent form.Before a bone biopsy, the patient needs to inform the doctor about the drugs they are taking. Your doctor may suggest that you stop certain medications a few days before the biopsy. In addition, the patient needs to tell the doctor if he is pregnant or has other health conditions, if any.
3. Procedure for performing bone biopsy under computed tomography
The patient is anesthetized locally with 2% Lidocaine, the amount of anesthetic is from 2-10ml depending on the biopsy site. Place the patient on the computed tomography table and establish an intravenous line. Take a picture to locate the bone to be biopsied, and stick a needle to position the needle. Computed tomography scan of the site to be biopsied. Computed tomography images help determine the expected point of needle puncture on the skin, puncture angle, and depth of puncture. The doctor marks the spot on the skin. Disinfect the area where the needle will be inserted. After disinfecting, the doctor washes his hands, puts on a shirt, wears gloves, and spreads a sterile towel with holes on the biopsy site. Apply local anesthetic in layers, then insert the biopsy needle in the intended direction of the puncture. Computed tomography determined the path and location of the puncture needle. When the needle is inserted into the right lesion, cut and take the specimen. When collecting the desired specimen, withdraw the needle, take the specimen in the needle, and fix the specimen for histopathological examination. Bandage the puncture site. During a bone biopsy under computed tomography, the patient may feel pressure or a brief sharp pain when the needle is inserted into the bone. You may also feel pain or pressure when the bone tissue sample is taken. After the biopsy, the patient may have pain that lasts up to a week.
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4. Complications can be encountered during bone biopsy under computed tomography and how to handle it
If there is bleeding from the puncture site, treat by applying pressure to the puncture site. Monitor the patient if there is soft tissue hematoma next to the needle puncture site.A small percentage is a broken device or a needle that damages blood vessels or nerves near the biopsy site. The doctor will treat each case on a case-by-case basis.
Bone biopsy is a test to diagnose bone diseases such as tumors, inflammation or cancer. The results of a bone biopsy will provide a lot of important information, helping the doctor decide on the treatment method for the patient. Therefore, patients should choose reputable medical facilities with modern machinery and equipment for the procedure.
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