乳腺微钙化灶活检过程中放置金属标记夹的筛选条件和影响标记夹移位的因素研究  

Screening conditions of metal marking clips placed in the biopsy of breast microcalcification and factors affecting the shift of marking clips

作　　者：王文武[1] 周余旺[2] WANG Wenwu;ZHOU Yuwang(Department of Thyroid and Breast Surgery,Quzhou People＇s Hospital in Zhejiang Province,Quzhou 324000,China;Department of Ultrasound Imaging,Quzhou People＇s Hospital in Zhejiang Province,Quzhou 324000,China)

机构地区：[1]浙江省衢州市人民医院乳甲外科,浙江衢州324000 [2]浙江省衢州市人民医院超声影像科,浙江衢州324000

出　　处：《中国现代医生》2018年第27期13-15,21,共4页China Modern Doctor

基　　金：浙江省衢州市指导性科技计划项目(20172046)

摘　　要：目的研究乳腺微钙化灶活检过程中放置金属标记夹的筛选条件和影响标记夹移位的因素。方法选取2017年1月～2018年1月我院接收治疗的120例患者,对所有患者的共153个乳腺微钙化灶进行11-gauge立体定位真空辅助乳腺活检,同时每个病灶放置金属标记夹。由固定的放射科医师对患者活检前、后行乳腺X线片检测,根据结果对钙化灶按照BI.RADS分类,观察钙化簇的大小、分布、数目以及钙化灶是否取净,同时分析标记夹移位发生的影响因素。结果 71处病灶为多簇微钙化病灶、A组、B组、C组的多簇靶灶的清除率分别为85.7%、76.0%、0%,组间比较差异有统计学意义(P<0.05)。68.5%的金属标记夹定位准确,32.5%的标记夹发生移位,其中35个标记夹沿着针道移位;标记夹移位的主要因素是血肿和"手风琴效应"(P<0.05)。结论直径20 mm以下的乳腺微钙化灶活检过程中放置金属标记夹的临床治疗效果理想,临床上应进一步推广应用。Objective To investigate the screening conditions for the placement of metal marking clips during biopsy of breast microcalcification and the factors affecting the shift of marking clips. Methods A total of 120 patients in our hospital from January 2017 to January 2018 were selected, 11-gauge stereotactic vacuum-assisted breast biopsy was performed on the 153 breast mieroealeifieations of all patients. Each lesion was placed with metal marking clips at the same time. The mammography was detected by a fixed radiologist before and after the biopsy of the patient. According to the results, the calcification was classified according to the BI. RADS. The size, distribution and number of calcified clusters were observed to determine whether or not the calcifications were removed clearly. At the same time, the influ- encing factors of the shift of marker clips were analyzed. Results The 71 lesions were clustered microcalcification. The clearance rates of muhiple clusters of target lesions in group A, group B, and group C were 85.7%, 76.0%, and 0%, respectively, and the difference was statistically significant （P〈0.05）. 68.5% of the metal marking clips were accurately positioned, 32.5% of the marking clips were shifted, and 35 marking clips were displaced along the needle trajectory. The main factors for the shift of the marker clips were hematoma and accordion effects（P〈0.05）. Conclusion It has a good clinical effect that the metal marking clips were placed during biopsy of diameter of breast microcalcification 〈20 ram, and the metal marking clips should be further promoted clinically.

关 键 词：乳腺 微钙化灶 标记夹 真空辅助 

分 类 号：R446.8[医药卫生—诊断学]