乳腺X线立体定位细针引导切检术的临床应用  

Clinical application of manipulating needle localization biopsy with stereotactic mammography

作　　者：柳杰[1] 张淑平[1] 赵玉梅[1] 刘佩芳[1] 

机构地区：[1]天津医科大学附属肿瘤医院乳腺影像诊断科/乳腺癌防治教育部重点实验室/天津市肿瘤防治重点实验室,天津300060

出　　处：《实用放射学杂志》2012年第7期1037-1039,1055,共4页Journal of Practical Radiology

摘　　要：目的最点闸述乳腺X线立体定位细针引导切检术在临床不可触及的乳腺病变应用中的操作技术要点。方法127例临床触诊阴性、乳腺X线片显示叮疑病变的患者，在X线立体定位引导下，将导丝滞留在病变处。外科医生将带有导丝的病变切除并送病理检奁。结果良性病变43例，其中腺纤维瘤12例，囊性增生9例，间质纤维组织增生8例，导管内乳头状瘤8例，慢性炎症4例，错构瘤1例，囊肿1例；恶性病变84例，其中浸润性导管癌48例，导管内癌31例，浸润性小叶癌5例。127例患者中116例定化满意，满意率为91．3％。同时与直接手术的48例患者比较病变切除的准确性，差异具有统计学意义（X^2=28．998，P〈0.005）。结论行乳腺X线泣体定位细针引导切检术的临床触诊阴性患者手术切除病变的准确性明显优于直接手术的患者。Objective To analyze the technical keys in manipulating needle localization biopsy with stereotactic mammography for nonpalpable breast lesions. Methods Stereotactic mammography needle localized biopsy was performed on 127 clinical negative breast lesions. After localization,all cases underwent entire excision by surgeons according to the steel wire implantation left in the le-sion and got pathological diagnosis. Results Postoperative pathologic findings revealed 43 benign lesions,including 12 fibroadenoma, 9 cystic hyperplasia, 8 st romal fibroplasia,8 intraductal papilloma,4 chronic inflammation, 1 hamartoma and 1 cyst, and 84 manignan-cy, including 48 invasive ductal carcinoma, 31 ductal carcinoma in situ, and 5 invasive lobular carcinoma. The operating localized biop sys in 116 of 127 patients（91.3%） were satisfactory. The difference of accuracy between biopsy and direct tumor resection in 48 pa-tients was significant statistically（X^2=28. 998,P〈0. 005）. Conclusion The accuracy of manipulating needle localization biopsy with stereotactic mammography for patients with nonpalpable lesions is higher than that of direct tumor resection.

关 键 词：乳腺 乳腺疾病 乳腺X线摄影 立体定位技术 活组织检查 

分 类 号：R655.8[医药卫生—外科学] R814.41[医药卫生—临床医学]