CT Guided Bone Marrow Aspiration and Core Biopsy

Carlos M Badiola,Folco Scappaticci,Driola Brahaj

doi:10.4236/ojrad.2012.22010

Abstract

Hemorrhagic complications related to bone marrow aspiration and trephine biopsy are uncommon. Risk factors include thrombocytopenia, myeloproliferative disorders, concurrent use of anticoagulants, and obesity. Here we describe our technique for bone marrow aspiration and biopsy of the posterior iliac crest using CT guidance. Our technique ensures needle passage only through subcutaneous fat and bone, avoiding muscle and neurovascular structures, as well as controlled and precise needle advancement within bone. This technique should be considered for use in patients that are at increased risk for procedure related complications, particularly obese patients, where surface anatomical landmarks may prove unreliable.

Highlights

Severe hemorrhagic complications related to bone marrow aspiration and trephine biopsy are rare [1]
Bone marrow aspiration and biopsy of the posterior iliac crest using surface anatomical landmarks is a safe and effective procedure that is most commonly performed for the evaluation of hematologic disorders
Severe hemorrhagic complications related to bone marrow aspiration and biopsy are due to improper needle placement and laceration of adjacent arteries, such as the superior gluteal artery or small muscular arteries, or the inadvertent passage of the needle through the targeted bone and into the retroperitoneum [3,4,5]

Summary

Introduction

Severe hemorrhagic complications related to bone marrow aspiration and trephine biopsy are rare [1]. Surface anatomic landmarks may be difficult to ascertain; thereby increasing the risk of injury to adjacent vascular or neural structures during bone marrow biopsy. The use of CT guidance ensures passage of the biopsy needle only through subcutaneous fat and bone, completely avoiding adjacent muscle and nearby neurovascular structures. This technique should be considered for use in patients that are at increased risk for procedure related complications, and in particular, obese patients, where surface anatomical landmarks may prove unreliable

Materials and Methods

Discussion