乳腺X线摄影引导下导丝定位在触诊阴性病灶切除术中的综合评价  

The comprehensive value of stereotactically guided wire localization biopsy of non-palpable breast lesions

作　　者：王倩[1] 赵心明[1] 宣立学[2] 李二妮[1] 李静[1] 周纯武[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院影像诊断科,北京100021 [2]北京中国医学科学院肿瘤医院乳腺疾病诊治中心,北京100021

出　　处：《医学影像学杂志》2014年第9期1491-1495,共5页Journal of Medical Imaging

摘　　要：目的综合评价导丝导向定位术在触诊阴性乳腺病灶中的应用价值。方法对84例触诊阴性乳腺病灶行导丝导向定位术103处,记录病灶大小、分布特征、标本体积、剂量参数和患者术中反应,评价病灶大小、特征、定位准确度对切除标本大小的影响以及定位术中辐射剂量和患者的耐受程度。结果定位适中74处,过深14处,过浅9处,完全偏离病灶靶点6处。1次性切除病灶99处,4处病灶2次切除,标本平均体积为11.47cm3。检出良性病变占59.2%(61/103处);不典型增生8.7%(9/103处);乳腺癌32.1%(33/103处)。定位术中辐射剂量近似为常规摄影辐射剂量的2倍,11例患者发生迷走反应。结论立体定位导丝导向定位术可在完整切除病灶的同时缩小手术范围,是目前应用于触诊阴性的乳腺病灶的有效方法。病灶大小、分布特征和定位准确度是影响病灶切除体积大小的重要因素,且术中的高辐射剂量及患者在术中的护理均值得关注。Objective To generally evaluate the clinical value of stereotactically guided wire localization biopsy of non- palpable breast lesions by mammography. Methods Stereotactically guided wire localization biopsy was performed on 84 patients （103 lesions）. The size and trait of lesion, the volume of specimen, the parameters of radiation dose and the re- sponse of patients were recorded. The affect that the veracity of localization worked on the volume of specimen, radiation dosage and patients＇endurance in biopsy were evaluated. Results Of 84 cases, good and bad localization resluts were a- chieved in 74 and 29 procedures, respectively. Resection of 99 lesions on single operation was achieved, 4 on double. The average volume of the resected specimens was 11.47 cm^3. The proportion of benign, dysplasia and malignantlesion was 59.2%, 8.7% and 32.l%. The radiation dosage in biopsy was approximately double as one in routine radiation. And pneumogastricreaetion happened on 11 patients. Conclusion Stereotactically guided wire localization biopsy was an effec- tive method for non-palpable breast lesions, which could resect the entire lesion without excessive excision. The lesion＇s size, trait and the veracity of localization was an important factor as to excision. High radiation dose and patients nursing in biopsy were worthy of attention.

关 键 词：导丝导向立体定位术 乳腺X线摄影 触诊阴性乳腺病灶 乳腺癌 

分 类 号：R814.3[医药卫生—影像医学与核医学] R737.9[医药卫生—放射医学]