X线导引下乳腺隐匿性病变蓝染医用胶活检术前标记法探讨

X-ray-guided Methylene Blue Dyed Medical Glue Localization Biopsy for Nonpalpable Breast Lesions

目的探讨利用常规钼靶乳腺设备对乳腺隐匿性病变作活检术前标记的简易方法。资料与方法对23例常规钼靶X线检查显示乳内成簇钙化灶、临床症状体征阴性患者采用穿刺针二维定位作钙化灶手术活检前美蓝染色医用胶标记,并通过医用胶的黏附作用,固定定位针于定位点作为手术路径指引。以针灶距作为定位针定位效果指标,钙化灶在蓝染组织中的位置、蓝染组织最大径线为染色胶定位效果指标。结果定位针定位优18例(78.3%),良4例(17.4%),差1例(4.3%);染色胶定位优17例(73.9%),良2例(8.7%),差4例(17.4%);术中定位针固定良好18例(78.3%),固定不良5例(21.7%)。20例(87.0%)一次完全切除钙化灶,切除组织最大径线2.2 cm,其中16例切除组织最大径线≤1.5 cm;2例(8.7%)2次完全切除,1例(4.3%)3次完全切除。结论染色医用胶术前标记法操作简单、准确、成本低廉,适合在基层医疗机构普遍推广,是乳腺癌早诊早治的有效方法。随着操作技术的不断熟练,钙化灶一次完全切除率将进一步提高。

Objective To evaluate the Localization value of methylene blue dyed medical glue for nonpalpable breast lesions biopsy.Materials and Methods Twenty three cases of clustered calcification in breasts without clinical symptoms and signs were collected in the study.Before surgery biopsy,the lesions were marked by methylene blue dyed medical glue,which was injected through positioning needles guided by two-dimensional mammography equipment.The positioning needle were fixed as a guide for surgical biopsy.The distance between needle and center of the lesion was regarded as the indicator of needle localization,while the position of lesions in the dyed tissues was regarded as the Indicator of dyed glue localization.Results Excellent,good and bad needle localization were observed in 18（78.3%）,4（17.4%） and 1（4.3%）cases.While excellent,good and bad dyed glue localization were observed in 17（73.9%）,2（8.7%） and 4 cases（17.4%）.Twenty（87.0%）cases of calcifications were completly removed by biopsy.Conclusion Blue dyed medical glue guided biopsy is a simple,easy,accurate and low cost method for diagnosis of nonpalpable breast calcifications.