中文摘要：

目的探讨CT导向立体定向活检手术的准确性及其在颅内疑难病例诊断中的价值.方法回顾性总结2009年1月至2010年9月间昆明医学院第一附属医院微创外科收治并行CT导向立体定向活检的23例病例,患者年龄10～75岁,平均（35±1）岁;其中男9例,女14例;病变位于额叶4例,颞叶1例,顶叶3例,枕叶5例,基底节区1例,丘脑1例,鞍区1例,多发病变7例.手术采用ASA-602S定向仪,所有靶点的活检均采用Sedan侧方开口活检针.结果病理诊断阳性率95.7%（22例）,其中星形细胞瘤3例,胶质瘤2例,胶质母细胞瘤1例,转移瘤1例,颅咽管瘤1例,海绵状血管瘤1例,感染性病灶1例,脑寄生虫3例,胶质增生7例,颅内异物1例,蛛网膜囊肿1例,阴性1例.活检后并发出血2例（8.70%）,死亡1例（4.35%）.结论CT引导的脑立体定向活检术诊断阳性率高、安全、可靠,既可达到定性诊断的目的,又可为下一步治疗提供可靠的病理学依据.

英文摘要：

Objective To explore the accuracy and role of computer tomography（CT）-guidedstereotactic biopsy for diagnosis of atypical diseases in brain.Methods The clinical data of 23 patients whounderwent CT-guided stereotactic biopsy between January 2009 and September 2010 were analyzedretrospectively.The ages of patients were between 10 and 75 years（mean age 35±1 years）.There were 9 malesand 14 femals.The lesions were located in front lobe in 4 patients,temporal lobe in 1 patient,parietal lobe in 3patient,occipital lobe in 5 patients,basal ganglion in 1 patient,thalamus in 1patient,sellar area in 1 patient,and multiple in 7 patients.We used ASA-602S stereotactic frame.We performed biopsies for each target using aSedan side-cutting needle.Results The positive diagnostic rate of pathological examination was 95.7%（22cases）.The result of the pathological diagnosis was astrocytoma in 3,neurospongioma troply in 2,glioblastomain 1,brain metastases in 1,craniopharyngioma in 1,cavernous malformation in 1,inflammatory lesion in 1,brain parasite disease in 3,hyperplasia of colloid cells in 7,intracranial foreign-body in 1,intracranialarachnoidal cyst in 1,and negative in 1 patient.Two cases（8.7%） showed asymptomatic hemorrhage and one case（4.35%） died.Conclusions CT-guided stereotactic biopsy is a safe and reliable method with high positive diagnostic rate.It is not only qualitative diagnosis,but also provides reliable histopathological basis for selecting further treatment.