立体定位穿刺活检术对乳腺微小病变定性诊断的探讨  

The Value of Stereotactic Localized Biopsy in Differential Diagnosis of Breast Minute Lesions

作　　者：葛玲玉[1] 黄强[1] 钱秉坤[1] 许顺良[1] 林冰影[1] 刘小蕉[2] 肖文波[1] 陈燕琼[1] 彭志毅[1] 

机构地区：[1]浙江大学医学院附属第一医院放射科,浙江杭州310003 [2]浙江大学医学院附属第一医院乳腺外科,浙江杭州310003

出　　处：《实用放射学杂志》2006年第4期457-459,共3页Journal of Practical Radiology

基　　金：浙江省卫生厅科研基金资助项目(2003A040)

摘　　要：目的提高乳腺X线立体定位核芯针活检(SCNB)、立体定位穿刺导丝定位活检(SNLB)对乳腺微小病变的定性诊断准确性及成功率。方法回顾性分析了118例乳腺微小病变立体定位穿刺导丝定位活检及核芯针活检的病理资料,并与手术病理结果进行对照。结果SCNB 33例中31例活检成功,24例行外科手术,恶性病变8例,良性病变16例,诊断符合率为87.5%,误诊3例(12.5%),7例随访。2例出现迷走神经反应,未完成检查。拟行SNLB 85例,83例定位成功,其中80例定位满意,满意率94%,3例定位偏离,2例定位失败,恶性病变30例,良性病变53例。结论SCNB及SNLB是目前对乳腺微小病灶定性诊断的主要方法,通过合理选择应用可提高诊断准确性及成功率。Objective To improve the accuracy and the success rate of stereotactic core needle biopsy （ SCNB ） or stereotactic needie localized biopsy （ SNLB ） in differential diagnosis of breast minute lasions. Methods 118 patients with minute loci detected by mammography underwent SCNB or SNLB , all data were analyzed retrospectively , and the pathology results of SCNB were compared with surgical pathologios. Results 31 Of all the 33 patients with SCNB were punctured successfully. 24 cases underwent surgical excision after SCNB ; 7 of these patients were followed - up by mammography , and the other 2 failed to undergo SCNB , because of vasovagal reaction. Postoperative findings showed 8 were malignant and 16 were benign . The concordance rate and the misdiagnosis rate was 87.5% , 12.5% respectively . Of the 85 cases of SNLB , 83 cases were successfully located , and 80 （ 94% ） cases were done satisfyingly , 3 departed . Pathologic findings revealed 30 were malignant and 53 were benign . 2 of 85 failed to be located. Conclusion SCNB and SNLB arc major approaches to diagnose breast minute lesions,reasonable application of the two methods can increase the accuracy and the success rate.

关 键 词：乳腺 微小病变 立体定位术 穿刺活检 

分 类 号：R655.8[医药卫生—外科学] R446.9[医药卫生—临床医学]