Stereotactic biopsies are an established tool for obtaining diagnosis of unclear brain lesions. However, non-diagnostic biopsies still occur. We aimed to analyze the contemporary diagnostic yield of stereotactic biopsies, predictors for non-diagnostic biopsies, outcome, and follow-up strategy after non-diagnostic biopsy. We conducted a single-center retrospective study of 311 adult patients undergoing stereotactic biopsies due to a newly diagnosed lesion at our department between 2012 and 2018. Patient data regarding comorbidities, presenting symptoms, imaging features, and non-invasive diagnostic procedures were obtained. The overall diagnostic yield was 86.2% and differed significantly between the various suspected diagnosis groups and was the highest when suspecting primary brain tumor compared with non-neoplastic lesions (91.2% vs. 73.3%, p > 0.001). Predicators for non-diagnostic biopsies were small lesion size, lack of contrast-enhancement, presence of sepsis, or underlying hemato-oncological disease. In case of non-diagnostic biopsy, a re-biopsy was performed in 12 cases, revealing a final diagnosis in 75%. In 16 cases, empiric therapy was started based on the suspected underlying disease. Close follow-up was performed in the remaining 15 cases. We showed that stereotactic biopsy is a safe procedure with reasonable diagnostic yield even for non-neoplastic lesions, when non-invasive diagnostic was inconclusive. In addition, we developed treatment recommendations for cases of non-diagnostic biopsies.

立体定向活检是获得不明确脑损伤诊断的既定工具。然而，非诊断性活检仍会发生。我们旨在分析立体定向活检的当代诊断率、非诊断活检的预测因子、结果和非诊断活检后的随访策略。我们对 2012 年至 2018 年间在我们科室因新诊断病变而接受立体定向活检的 311 名成年患者进行了单中心回顾性研究。获得了有关合并症、症状、影像学特征和非侵入性诊断程序的患者数据。总体诊断率为 86.2%，在各种疑似诊断组之间差异显着，与非肿瘤性病变相比，怀疑原发性脑肿瘤时最高（91.2% 对 73.3%，p > 0.001)。非诊断性活检的预测指标是病变尺寸小、缺乏对比增强、存在败血症或潜在的血液肿瘤疾病。在非诊断性活检的情况下，对 12 例进行了重新活检，最终诊断率为 75%。在 16 例中，根据疑似基础疾病开始经验性治疗。其余15例进行密切随访。我们表明，当非侵入性诊断尚无定论时，即使对于非肿瘤性病变，立体定向活检也是一种安全的方法，具有合理的诊断率。此外，我们为非诊断性活检病例制定了治疗建议。