临床不能触及乳腺病变影像引导下导丝定位手术切检的研究  

Clinical application of imaging-guided hook wire-localized surgical biopsy in diagnosing impalpable breast lesions

作　　者：刘琳[1] 周庆华[2] 王忠敏[1] 陆健[1] 张丽云[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院放射科,200020 [2]上海交通大学医学院附属瑞金医院卢湾分院乳腺科,200020

出　　处：《介入放射学杂志》2014年第12期1088-1091,共4页Journal of Interventional Radiology

基　　金：上海市黄浦区卫生局课题(2012-HGG-11)

摘　　要：目的评价临床不能触及乳腺病灶影像引导下放置钩丝定位引导手术切检的有效性及安全性。方法回顾性分析61例临床触诊阴性而乳腺钼靶X线或B超显示的微小病灶诊治过程。其中32例采用乳腺钼靶X线定位下穿刺,29例采用B超定位下穿刺,留置导丝于微小病灶区,引导手术将病灶切除活检。结果 32例钼靶穿刺引导均一次性定位成功,定位满意率93.8%,病灶完整切除。穿刺定位平均时间15.6 min,平均摄片5次。29例B超穿刺引导,所有病灶均完整切除,术中发现导丝均位于病灶内。所有患者均未出现导丝移位、气胸、大出血等并发症。结论影像引导穿刺钩针定位简单易行,是诊治临床不能触及乳腺病变安全、有效的方法。Objective To assess the efficacy and safety of imaging- guided hook wire- localized surgical biopsy in diagnosing impalpable breast lesions. Methods A total of 61 female patients, who had micro-lesions on mammography or ultrasonography but had negative mammary palpation, were enrolled in this study. Of the 61 patients, imaging-guided hook wire-localized puncturing biopsy was carried out in 32 and ultrasound-guided puncturing biopsy was performed in 29. After puncturing, the hook wire was left in the tiny lesion region to guide the surgical excision biopsy. The clinical results were retrospectively analyzed. Results Mammography- guided hook wire localization was successfully performed with single procedure in all 32 patients, the satisfaction of localization was 93.75%, and the lesions were completely removed. The mean time for puncturing localization was 15.6 minutes, and the mean radiography films taken for each case was five. In 29 patients receiving ultrasound-guided puncturing biopsy, the lesions were totally excised, and the operation showed that the hook wire was within the lesion in all cases. No major complications such as displacement of guide wire, pneumothorax, massive hemorrhage, etc. occurred. Conclusion Image-guided hook wire- localized surgical biopsy is technically simple and easily-manipulated. It is a safe and effect method for the diagnosis of impalpable breast lesions. （J Intervent Radiol, 2014, 23： 1088- 1091）

关 键 词：临床不能触及乳腺病变 钩针 定位 乳腺X线摄影 超声 

分 类 号：R655.8[医药卫生—外科学]