一种简便的磁共振成像引导下乳腺可疑病灶徒手穿刺定位技术  

A simple bare-handed technique for magnetic resonance imaging guided needle localization of suspicious breast lesions

作　　者：张庆[1,2] 庄治国[1] 华佳[1] 成芳[1] 华小兰[1] 李岚[1] ZHANG Qing;ZHUANG Zhiguo;HUA Jia;CHENG Fang;HUA Xiaolan;LI Lan(Department of Radiology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Radiology,Renji Hospital South Campus,Shanghai Jiao Tong University School of Medicine,Shanghai 201112,China)

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200127 [2]上海交通大学医学院附属仁济医院南院放射科,上海201112

出　　处：《肿瘤影像学》2020年第3期265-271,共7页Oncoradiology

摘　　要：目的:评估一种简便的磁共振成像(magnetic resonance imaging,MRI)引导下乳腺可疑病灶徒手穿刺定位技术的临床应用价值。结果:本研究共纳入273例1.5T MRI引导下徒手穿刺定位患者,所应用的穿刺方法类似于CT引导下肺结节穿刺定位技术,对其临床资料进行回顾并分析,比较2名具有不同乳腺穿刺经验水平的放射科医师的定位准确率和手术时间。结果:本研究共定位273个乳腺可疑病灶,定位成功率100.0%(273/273),其中高经验医师定位186个,低经验医师定位87个。病理学检查结果:恶性病变36例(13.2%),高危病变46例(16.8%),良性病变191例(70.0%)。手术时间5~30 min,平均14.3 min,高经验医师定位手术时间5~27 min[平均(12.98±3.77)min],低经验医师定位手术时间7~30 min[平均(17.11±5.07)min]。两组不同医师手术所需时间差异有统计学意义(P<0.001)。除少数穿刺后有轻微血肿(7例,2.6%)外,无其他明显并发症。结论:本研究所采用的MRI引导下乳腺可疑病灶徒手穿刺定位技术是一种简便、安全、快速、准确的操作方法;并可对一些位于乳腺腋窝区、乳晕区和胸壁附近的特殊部位的病灶进行定位;在临床应用中可有助于早期诊断。Objective:To evaluate the clinical application of MRI-guided needle localization of suspicious breast lesions by using a convenient bare-handed method.Methods:A total of 273 patients who received needle localization with a bare-handed technique for suspicious breast lesions by using 1.5T MRI-guided were included in this study.The puncture method was similar to CT-guided needle localization of lung nodule.The clinical data was retrospectively analyzed.The accuracy of localization and time spent for the procedure were compared between two independent radiologists with different levels of experience.Results:A total of 273 lesions were analyzed.The success rate of MRI-guided localization was 100.0%(273/273)in both radiologists,radiologist with high level of experience was 186/186 and radiologist with low level of experience was 87/87.After surgery resection,the pathological diagnoses were as follows:36(13.2%)malignant lesions,46(16.8%)high-risk lesions,and 191(70.0%)benign lesions.Procedure time of all the cases ranged from 5 to 30 min(mean,14.3 min).Procedure time of radiologist with high level of experience was from 5 to 27 min[mean,(12.98±3.77)min],and radiologist with low level of experience ranged from 7 to 30 min[average,(17.11±5.07)min].There was statistically significant difference in the puncture time between the two radiologists(P<0.001).Except a small number of patients who had a slight hematoma after puncture(n=7,2.6%),there were no significant complications.Conclusion:MRI-guided bare-hand needle localization of suspicious breast lesions is a handy,safe,rapid,and accurate interventional method.The lesions that are located at axillary region of breast,areola area,and the special area near the chest wall can all be precisely localized.In clinic,this MRI-guided puncture localization can be applied to improve early diagnosis and treatment.

关 键 词：磁共振成像 乳腺 徒手 穿刺定位 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]