数字乳腺X线断层摄影定位与二维立体定位下乳腺病变不同活检方式的比较研究  

Comparison of digital breast tomosynthesis-guided and stereotactic-guided biopsy for breast lesions

作　　者：杨玉婷 廖婷婷 林小慧 欧阳汝珊 李霖 赖小慧 戴懿[5] 马捷 Yang Yuting;Liao Tingting;Lin Xiaohui;Ouyang Rushan;Li Lin;Lai Xiaohui;Dai Yi;Ma Jie(the Second Clinical Medical College,Jinan University,Shenzhen 518020,China;Department of Radiology,Shenzhen People's Hospital,Shenzhen 518020,China;Department of Radiology,the Eighth Afiliated Hospital of Sun Yat-sen University,Shenzhen 528406,China;Department of Radiology,Luohu People's Hospital,Shenzhen 518000,China;Department of Radiology,Peking University Shenzhen Hospital,Shenzhen 518036,China)

机构地区：[1]暨南大学第二临床医学院,深圳518020 [2]深圳市人民医院放射科,深圳518020 [3]中山大学第八附属医院放射科,深圳528406 [4]深圳市罗湖区人民医院放射科,深圳518000 [5]北京大学深圳医院放射科,深圳518036

出　　处：《中华放射学杂志》2024年第9期916-922,共7页Chinese Journal of Radiology

基　　金：深圳市科技研发资金(GJHZ20220913142613025)。

摘　　要：目的比较数字乳腺X线断层摄影(DBT)定位与立体定位下乳腺病变穿刺活检的临床应用价值。方法该研究为横断面研究。回顾性分析2021年8月至2023年10月在深圳市人民医院、深圳市罗湖区人民医院及北京大学深圳医院接受乳腺活检的患者250例,其中DBT定位下活检136例(DBT定位组)、立体定位下活检114例(立体定位组)。立体定位组穿刺活检方法包括核芯针穿刺活检(CNB)和金属丝定位,DBT定位组穿刺活检方法包括CNB、金属丝定位、真空辅助乳腺活检(VABB)。采用χ2检验或Mann-Whitney U检验比较2组不同活检方法的穿刺成功率、操作时间、定位时间、穿刺时间、获得首张有效定位相的次数、曝光次数、并发症情况。结果金属丝定位活检中,DBT定位组穿刺成功率为100%(33/33),立体定位组穿刺成功率为96%(48/50),二者差异无统计学意义(P=0.515);与立体定位组比较,DBT定位组操作时间、定位时间更短,获得首张有效定位相的次数、曝光次数更少(P<0.05);DBT定位组与立体定位组并发症发生率均较低,差异无统计学意义(P=0.871)。CNB中,DBT定位组与立体定位组穿刺成功率均较高,差异无统计学意义(P=0.080);与立体定位组比较,DBT定位组操作时间、定位时间、穿刺时间短,获得首张有效定位相的次数、曝光次数少,二者差异具有统计学意义(P<0.05);DBT定位组与立体定位组并发症发生率均较低,差异无统计学意义(P=0.627)。21例接受DBT下VABB,操作时间为(19.90±3.38)min,定位时间为6.00(6.00,7.00)min,穿刺时间为(13.42±3.28)min,获得首张有效定位相次数为1.00(1.00,1.00)次,曝光次数4.00(3.50,5.00)次,1例穿刺后出现剧烈疼痛。结论与立体定位活检比较,DBT定位活检可减少操作时间及曝光次数,且能针对更多乳腺病变类型,临床应用价值更高。ObjectiveTo compare the clinical value of digital breast tomosynthesis(DBT)localization and stereotactic positioning biopsy of breast lesions.MethodsThis study was a cross-sectional study.Totally of 250 patients who underwent breast biopsy at Shenzhen People′s Hospital,Luohu District People′s Hospital and Peking University Shenzhen Hospital between August 2021 to October 2023 was analyzed retrospectively,including 136 cases of DBT-guided biopsy(DBT-guided group)and 114 cases of stereotactic-guided biopsy(stereotactic-guided group).The stereotactic-guided biopsy methods included core needle biopsy(CNB)and wire positioning.The DBT-guided biopsy methods included CNB,wire positioning and vacuum-assisted breast biopsy(VABB).Theχ2 test or Mann-Whitney U test was used to compare the puncture success rate,operation time,localization time,puncture time,number of first valid localization phases obtained,number of exposures,and complications of different biopsy methods between 2 groups.ResultsIn the wire positioning biopy,the puncture success rate was 100%(33/33)in DBT-guided group and 96%(48/50)in the stereotactic-guided group,with no statistically significant difference between the two groups(P=0.515).Compared to the stereotactic-guided group,the operation time and localization time were shorter,and the number of first valid localization phases obtained,number of exposures were fewer in the DBT-guided group(P<0.05).The incidence of complications was lower in both the DBT-guided group and the stereotactic-guided group,with no statistically significant difference(P=0.871).In CNB,both the DBT-guided group and the stereotactic-guided group had higher puncture success rates,with no statistically significant difference(P=0.080).Compared to the stereotactic-guided group,the operation time,localization time and puncture time were shorter,and the number of first valid localization phases obtained,number of exposures were lower in the DBT-guided group,and the difference between the two groups were statistically significant(P<0

关 键 词：乳腺肿瘤 活组织检查 X线 断层定位 立体定位 

分 类 号：R737.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]