PDF(Pubmed)
Abstract：
OBJECTIVE: Muscle biopsy techniques range from needle muscle biopsy (NMB) and conchotome biopsy to open surgical biopsy. It is unknown whether specific biopsy techniques offer superior diagnostic yield or differ in procedural complication rates. Therefore, we aimed to compare the diagnostic utility of NMB, conchotome and open muscle biopsies in the assessment of neuromuscular disorders.
METHODS: A systematic literature review of the EMBASE and Medline (Ovid) databases was performed to identify original, full-length research articles that described the muscle biopsy technique used to diagnose neuromuscular disease in both adult and paediatric patient populations. Studies of any design, excluding case reports, were eligible for inclusion. Data pertaining to biopsy technique, biopsy yield and procedural complications were extracted.
RESULTS: Sixty-four studies reporting the yield of a specific muscle biopsy technique and, or procedural complications were identified. Open surgical biopsies provided a larger tissue sample than any type of percutaneous muscle biopsy. Where anaesthetic details were reported, general anaesthesia was required in 60% of studies that reported open surgical biopsies. Percutaneous biopsies were most commonly performed under local anaesthesia and despite the smaller tissue yield, moderate- to large-gauge needle and conchotome muscle biopsies had an equivalent diagnostic utility to that of open surgical muscle biopsy. All types of muscle biopsy procedures were well tolerated with few adverse events and no scarring complications were reported with percutaneous sampling.
CONCLUSIONS: When a histological diagnosis of myopathy is required, moderate- to large-gauge NMB and the conchotome technique appear to have an equivalent diagnostic yield to that of an open surgical biopsy.
METHODS: A systematic literature review of the EMBASE and Medline (Ovid) databases was performed to identify original, full-length research articles that described the muscle biopsy technique used to diagnose neuromuscular disease in both adult and paediatric patient populations. Studies of any design, excluding case reports, were eligible for inclusion. Data pertaining to biopsy technique, biopsy yield and procedural complications were extracted.
RESULTS: Sixty-four studies reporting the yield of a specific muscle biopsy technique and, or procedural complications were identified. Open surgical biopsies provided a larger tissue sample than any type of percutaneous muscle biopsy. Where anaesthetic details were reported, general anaesthesia was required in 60% of studies that reported open surgical biopsies. Percutaneous biopsies were most commonly performed under local anaesthesia and despite the smaller tissue yield, moderate- to large-gauge needle and conchotome muscle biopsies had an equivalent diagnostic utility to that of open surgical muscle biopsy. All types of muscle biopsy procedures were well tolerated with few adverse events and no scarring complications were reported with percutaneous sampling.
CONCLUSIONS: When a histological diagnosis of myopathy is required, moderate- to large-gauge NMB and the conchotome technique appear to have an equivalent diagnostic yield to that of an open surgical biopsy.
摘要：
肌肉活检技术的范围从针状肌肉活检（NMB）和电磁切片机活检到开放式手术活检。尚不清楚特定的活检技术是否可提供更高的诊断率或手术并发症发生率不同。因此,我们的目的是比较NMB的诊断效用，神经肌肉疾病评估中的共形和开放式肌肉活检。对EMBASE和Medline（Ovid）数据库进行了系统的文献综述，以确定原始的，全长研究文章，描述了用于诊断成人和儿科患者人群神经肌肉疾病的肌肉活检技术。任何设计的研究，不包括病例报告，有资格列入。有关活检技术的数据，活检产量和手术并发症被提取。64项研究报告了特定肌肉活检技术的产量，或发现手术并发症。开放式手术活检提供了比任何类型的经皮肌肉活检更大的组织样本。在报告麻醉细节的地方，在报告开放性手术活检的研究中,60%需要全身麻醉.经皮活检最常见的是在局部麻醉下进行，尽管组织产量较小，中到大口径针头和外耳镜肌肉活检具有与开放式手术肌肉活检相当的诊断效用.所有类型的肌肉活检程序都具有良好的耐受性，很少发生不良事件，并且经皮取样未报告瘢痕并发症。因此,当需要诊断肌病时，中、大规格NMB的诊断率与开放式手术活检的诊断率相当。
