立体导丝定位和大体定位在网格辅助下对触诊阴性乳腺癌微钙化的诊断价值  

The diagnostic value of stereotactic wire localization and usual localization combined with mesh in the NBPL microcalcification

作　　者：夏德新[1] 李德春[1] 王光明[1] 赵莉[1] 

机构地区：[1]江苏省徐州市中心医院放射科,江苏徐州221009

出　　处：《医学影像学杂志》2018年第2期237-241,共5页Journal of Medical Imaging

基　　金：江苏省徐州市科学技术局社会发展项目(编号:KC15SH061)

摘　　要：目的探讨乳腺X线三维立体定位术和大体定位结合网格在临床检查阴性乳腺癌微钙化病变中的诊断价值。方法 25例患者乳腺X线发现钙化而接受立体定位术,42例患者大体定位。手术活检,术后在自制网格辅助下行病理学检查。结果 25例导丝定位患者,全部一次性成功,成功率100%,42例大体定位患者,3例二次扩大切除手术,其一次成功率92.86%。单纯钙化表现27例,结构扭曲伴钙化23例,致密影伴钙化计17例。其中恶性病变33例,良性病变34例。两组间准确率及满意度经2分析,P<0.05,有统计学意义。结论乳腺钙化是诊断早期乳腺癌的重要征象,X线立体穿刺导丝定位活检是对乳腺微小钙化定位定性诊断首选而有效的方法,其准确性、满意度均优于大体定位,而大体定位经济性及操作时间上优于导丝定位,而结合我科自制网格可以缩短病理取材时间,指导外科再次切除。Objective To evaluate the diagnostic value of digital three-dimensional wire localization and mammography locali- zation combined with homemade metal mesh in the breast mierocaleification of nonpalpable breast lesions. Methods A total of 67 patients underwent X-ray examination and were found microcalcification. Then three-dimensional stereotatic localization was performed on 25 patients. With the stereotatic wire localization and surgical biopsy, the calcification was localized and removed. Pathological examination was done after the surgery. Results Three-dimensional stereotatic localization was all well done in 25 patients（ 100% ）, then mammography localization in 42 patients, while 3 patients were deviated, the first successful rate was 92. 86%. Mammography showed that only microcalcification was found in 27 cases, calcification with disorganization in 23 cases, calcification with increased density in 17 cases. Pathologic findings revealed that 33 patients were malignant and 34 patients were benign. After statistical analysis （ P 〈 0.05 was statistically significan）, the accuracy and santisfaction of the wire localization were better. Conclusion Three-dimensional stereotatic localization of breast contributes to the detection and diagnosis of early- stage breast cancer and microcaleification and increases the detection rate of the nonpalpable breast lesions. The method of wire localization is efficient than the mammography in accuracy and satisfaction, then the mammography localization is better than it in economic and operation time. With our metal mesh, the pathological examination time will be shortened and it can benefit the sur- gical re-resection.

关 键 词：不可触及乳腺癌 立体定位技术 乳腺X线 导丝定位 

分 类 号：R737.9[医药卫生—肿瘤] R812[医药卫生—临床医学]