Air Injection into the Stereotactic Biopsy Site in Cerebral Lesions; A Feasibility Study

Sohrab Shahzadi¹, Bahram Hejrani^2*, Alireza Zali¹, Hamed Javadian³ and Khosro Parsa⁴

¹Department of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

²Neurosurgeon, Fellow of Stereotactic and Functional Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

³Resident of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

⁴Department of Neurosurgery , Iran University of Medical Sciences, Tehran, Iran.

Corresponding Author E-mail: b.hejrani@gmail.com 

DOI : http://dx.doi.org/10.13005/bbra/2292

ABSTRACT: We assessed the utility and safety of injecting a small amount of air into the stereotactic biopsy site. Specifically, we wanted to know whether it helps in visualizing the target on a post-op brain CT scan. In this clinical series, we chose our subjects by consecutive sampling, among candidates for frame-based stereotactic biopsy of a supratentorial cerebral lesion. By applying certain inclusion and exclusion criteria, twenty cases were biopsied by two surgeons in a four-month period. After obtaining the tissue sample, we injected 0.5-1 ml of filtered room air through the biopsy cannula. The immediate post-op CT scan was evaluated by two researchers for the presence and location of the air bubble. The subjects consisted of 12 male and 8 female patients, 10-76 years old. The histologic diagnosis rate was 100%; 60% high – grade glioma, 20% low-grade glioma,  10% metastasis and one case of meningioma and brain abscess. The air bubble could be visualized in all cases within the lesion territory. In two cases (10%) bubbles were also found in other locations. There was no neurologic or radiologic complications. Our findings substantiates the limited available literature in regard with safety and diagnostic usefulness of air bubbles. Further research is needed to verify and quantify the diagnostic impact and any complications attributable to this measure.

KEYWORDS: Stereotactic Biopsy; Air Injection; Post-op CT Scan

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