数字化三维立体导丝定位术在NPBLs诊断中的价值  

The valuation of 3D guide-wire localization technique with digital mammography for diagnosing NPBLs

作　　者：赵莉[1] 李德春[1] 杨玉娥[1] 刘秋红[1] 

机构地区：[1]江苏省徐州市中心医院放射科,221009

出　　处：《中华全科医学》2014年第11期1817-1819,共3页Chinese Journal of General Practice

摘　　要：目的探讨数字化钼靶x线引导下三维立体导丝定位穿刺术对NPBLs的诊断价值及意义。方法对53例NPBLs患者、据乳腺影像报告系统（BI-RADS）分类为BI—RADS4—5类及部分3类因顾虑过多自己要求活检的患者，采用X线引导下三维导丝立体穿刺定位，术后行病理学检查的临床资料进行回顾性分析。结果53例患者中诊断为BI—RADS4类39例，其中4a类9例，4b类12例，4c类18例，BI—RADS5类9例，BI—RADS3类因患者顾虑过多强烈要求活检5例，所有患者均一次性定位成功，病变完全切除，术后病理结果示：恶性病变32例（60．3％），其中浸润性导管癌16例（30．0％），导管内原位癌11例（21．0％），小叶原位癌4例（7．0％），黏液腺癌1例（1．0％）；良性病变21例（39．7％），其中乳腺纤维腺瘤10例（19．0％），乳腺腺病5例（9．0％），非典型增生3例（6．0％），乳腺囊肿2例（4．0％），导管内乳头状瘤1例（1．0％）。结论乳腺数字化三维立体导丝定位穿刺术操作方法简单、安全性高、定位准确，在病灶切除完全的同时，切除组织少，同时，对NPBLs的诊断与治疗具有十分重要的价值。Objective To investigate the clinical value and significance of 3 D guide-wire localization technique with digital mammography in the diagnosis of breast nonpalpable lesions （NPBLs）. Methods 53 cases, according to Breast ima- ging reporting and data system（ BI-RADS）, to be classified BI-RADS 4 -5 and BI-RADS 3 requesting biopsy by oneself because of scrupulosity,which by using the 3D guide-wire localization technique with digital ammography to guide the surgery to excise biopsy, then underwent postoperative pathological examination. The results were analyzed retrospectively. Results 53 cases included 39 cases of BI-RADS 4,9 cases of which are BI-RADS 4a, 12 cases of which are BI-RADS 4b, 18 cases of which were BI-RADS 4c,and 9 cases of BI-RADS 5 ,and 5 cases of BI-RADS 3 requesting biopsy by one- self because of scrupulosity, all 53 lesions were localized successfully and excised completely. The pathologic findings revealed 32 cases were malignant （60.3 % ）, including 16 cases of invasive ductal carcinoma （30.0%）, 11 cases of ductal carcinoma in situ （ 21.0% ）, 4 cases of lobular carcinoma in situ （ 7.0% ） and 1 case of mucous adenocarcinoma （ 1.0% ）. The pathologic findings revealed 21 cases were benign （ 39.7% ）, including 10 cases of breast fibroadenoma （ 19.0% ） ,5 cases of adenosis of breast（9.0% ） ,3 cases of atypical hyperplasia（6.0% ） ,2 cases of breast cyst（4.0% ） and 1 case of intraducal papilloma（ 1.0% ）. Conclusion 3D guide-wire localization technique with digital mammography was simply, safely and accurately. The NPBLs was excised completely meanwhile mammary tissue was excised less. It was very important valuable that the NPBLs can be diagnosed and treated accurately.

关 键 词：乳腺 触诊阴性乳腺病变 导丝定位 数字化X线摄影 

分 类 号：R814.4[医药卫生—影像医学与核医学] R655.8[医药卫生—放射医学]