钼靶钩丝定位在切除触诊阴性的BI-RADS Ⅳ级以上乳腺病变中的意义  

The significance of breast mammography assisted by hook-wire localization biopsy for BI-RADS Ⅳ and above negative breast lesions

作　　者：李航[1,2] 苏建辉[1,3] 张颖[1] Lavneesh Kumar 张杰[1,2] 杨帅[1,2] 张风华[1,5] 

机构地区：[1]河北省人民医院,石家庄市050051 [2]河北医科大学研究生学院 [3]河北省人民医院医学影像科 [4]河北医科大学国际学院 [5]河北省人民医院腺体外科

出　　处：《中国肿瘤临床》2014年第20期1318-1322,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨乳腺钼靶X线摄影引导下钩丝定位活检技术对临床触诊阴性或触诊不良的BI-RADSⅣ级及以上乳腺病变的诊断意义。方法:选取2012年1月至2014年8月48例乳腺钼靶BI-RADSⅣ级及以上但临床触诊阴性或触诊不良的乳腺病变患者(其中双侧病变4例、单侧病变44例、共计52处病灶),进行钼靶X线摄影引导下钩丝定位活检术。结果:所有52处病灶中恶性病变13例(均单侧),其中0期占46.15%(6/13),Ⅰ期占38.46%(5/13),Ⅱ期占15.39%(2/13);良性病变39例,乳腺癌检出率为25.0%。钼靶BI-RADSⅣ级患者中良性病变39例,恶性病变10例;BI-RADSⅤ级患者中良性病变0例,恶性病变3例。Ⅳ、Ⅴ级中乳腺癌的阳性检出率分别为25.6%和100%。结论:钼靶辅助下钩丝定位活检可以精确切除临床触诊阴性或触诊不良的BI-RADSⅣ级及以上乳腺病灶,提高患者生活质量和改善预后,是一种安全、准确、费用低廉的诊断方法,值得国内临床广泛推广。Objective：To evaluate the diagnosis significance of breast mammography assisted by hook-wire localization biopsy for BI-RADSⅣand above negative or non-palpable breast lesions. Methods：A total of 48 cases of mammary molybdenum target with BI-RADSⅣlevel and above but with clinical-touched negative or non-palpable breast lesions （including 4 bilateral lesions and 44 uni-lateral lesions;total of 52 lesions） were used in the mammography aided by hook-wire localization biopsy. Results：Among the 52 le-sions, 13 cases were malignant lesions （single）, 6 cases were at Stage 0 （accounted for 46.15%）, 5 cases were in Stage I （38.46%）, and 2 cases were in StageⅡ（15.39%）. The remaining 39 cases were benign lesions. Results showed that the detection rate for breast cancer was 25.0%. A total of 39 cases of benign lesions and 10 cases of malignant lesions were found among mammography BI-RADSⅣpa-tients. Zero cases of benign lesions and 3 cases of malignant change were found among BI-RADS Ⅴ patients. The positive rates of breast cancer among BI-RADSⅣandⅤpatients were 25.64%and 100%, respectively. Conclusion：Breast mammography assisted by hook-wire localization biopsy could precisely excise both BI-RADSⅣandⅤnegative/non-palpable breast lesions. This technique can also improve the quality of life and prognosis of patients. It is a safe, accurate, and low-cost diagnostic method. Thus, breast mammogra-phy assisted by hook-wire localization biopsy must be widely used in clinical applications in China.

关 键 词：乳腺钼靶 触诊阴性 乳腺肿瘤 放射影像技术 BI-RADS分级 

分 类 号：R737.9[医药卫生—肿瘤]