目的 探讨CT引导下经皮穿刺活 检的穿刺路径及器械选择的方法，分析 依据PET-CT确定靶点对活检准确率的影 响。方法 180例脊柱病变患者，包括胸 椎101例、腰椎79例，采用CT监测下经皮 穿刺活检的方法获得病理诊断。分别依据 CT和MRI确定靶点和依据PET-CT确定靶点 依病变的部位的准确率。结果 180例中 178例获得明确病理诊断，普通活检阳性 率90.2％。PET-CT靶向引导活检阳性率为 98.62％。手术80例，平均随访27个月， 证实PET-CT确定靶点可以提高活检准确 率，无并发症发生。结论 CT引导下经皮 穿刺活检是脊柱病变术前明确诊断的有效 方法，其安全、准确率高、费用低，依据 PET-CT确定靶点可以提高活检准确率。

Objective To determine the accuracy of CT-guided spinal biopsy benefitted from PET-CT, to compare the results with those without PET-CT, and to determine if PET-CT influence the accuracy of CT-guided thoracic spinal biopsy. Methods In total, 180 consecutive CT-guided percutaneous thoracolumbar spine procedures (performed at the Department of Spinal Surgery, Xi'an Red Cross Hospital between April 2000 and July 2014) were reviewed. The 180 lesions were categorized by CT or MRI. Pathological and clinical follow-up were used to determine accuracy. Results The diagnostic accuracy of CT-guided spinal biopsy was 93.5% overall. CT-guided spinal biopsy benefitted from PET-CT (98.62%) was significantly more accurate than biopsies of general (90.12%) (P <0.05 ). Conclusion Percutaneous CT-guided spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was improved by PET-CT.