数字化乳腺X线立体穿刺定位摄影技术在病灶切除术中的应用

The application of stereotaxic puncturation photography guided by digital mammograph in lesion resection

目的:探讨全数字化乳腺X线引导术前病灶立体定位穿刺摄影技术的操作方法及临床应用价值。方法:对20例临床触诊阴性或疑似触及小肿块,而乳腺摄影有异常的患者,行数字化乳腺X线引导下术前病灶立体穿刺定位,病灶内留置导丝指导临床手术切除病灶。结果:20例患者,穿刺成功18例,2例失败。成功率达90%。病理诊断结果:4例纤维瘤伴乳腺增生;8例为乳腺腺体增生和钙化灶,部分增生活跃;2例为导管内癌,3例为浸润性乳腺癌Ⅰ期;1例原位癌。结论:全数字化乳腺X线引导下术前病灶立体定位穿刺摄影技术方便、快捷、定位准确率高,为临床上不可扪及乳腺病灶手术提供了有效的影像信息,达到了手术病灶切除范围更精确、组织损伤更小;病理诊断更准确。

Objective.. To study operation method and clinical value of the stereotaxic puncturation photography guided by full digital mammography before operation. Methods：The group was composed of 20 cases of patients. For them, clinical palpation showed negative or doubtful little tumors, but mammography revealed abnormal. The stereotaxic puncturation was done guided by full digital mammography, and the indwelling wire was placed to guide clinical resection of lesions by operation. Results： Among 20 cases, 18 were successful and 2 failed. So the achievement ratio was 900%. Pathology showed that 4 cases had fibroma and hyperplasia, 8 cases had mammary gland hyperplasia and calcification with part of active proliferation, 2 cases were intraductal carcinoma, 3 cases were invasive breast cancer of stage I , and 1 case was carcinoma in situ. Conclusion：The stereotaxic puncturation photography guided by full digital mammography before operation of lesions is convenient, rapid and high accuracy of location. It provides efficient imaging information for operations of breast lesions which are not palpable, so there will be more precise resection range of lesions and less tissue damage, even pathological diagnosis will be more accurate.