0.4T全开放式和1.5T MR引导下乳腺病灶徒手穿刺定位法的临床应用

Clinical application of 1.5T and 0.4T MRI-guided needle localization of breast lesions with bare-handed puncture technique

目的评估EMT-100辅助下0.4T全开放式MR引导与1.5T MR引导乳腺病灶两种徒手穿刺定位法的临床应用价值。方法回顾分析322例EMT-100辅助下0.4T全开放式MR引导以及43例1.5T MR引导乳腺病灶两种徒手穿刺定位法的定位准确性及手术耗时。结果 322例采用0.4T MR引导下穿刺定位法患者中294例(91.3%)定位成功,26例(8.1%)定位失败,手术耗时16~52 min(平均(28.20±6.11)min;43例采用1.5T MR引导下穿刺定位法患者中40例(93%)定位成功,1例(2.3%)定位失败,手术耗时8~46 min,平均(17.19±6.64)min;两者定位准确性差异无统计学意义(P值=0.179);1.5T MR引导手术耗时明显短于0.4T MR引导(P<0.01)。结论两种MR引导下乳腺病灶徒手穿刺定位法定位准确性均高,手术时间短,并可定位靠近腋尾区、乳晕区及胸壁的特殊区域病灶。

Objective To evaluate the clinical application of MRI-guided needle localization of suspicious breast lesions by using two bare- handed methods： EMT- 100 assisted 0.4T fully- opened MR- guided technique and 1.5T MR- guided technique. Methods A total of 322 patients who received bare- handed puncture for suspicious breast lesions by using EMT-100 assisted 0.4T fully-opened MR-guided needle localization technique and 43 patients who received bare-handed puncture for suspicious breast lesions by using 1.5T MR-guided needle localization technique were included in this study. The clinical data were retrospectively analyzed. The localization accuracy and time spent for the procedure were compared between the two methods. Results EMT-100 assisted OAT fully-opened MR-guided needle localization technique was employed in 322 patients, successful localization of the lesion was achieved in 294 patients （91.3%） and failure of localization occurred in 26 patients （8.1%）. The time spent for the procedure ranged from 16 rain to 52 min, with a mean of （28.20±6.11） min. 1.5T MR-guided needle localization technique was adopted in 43 patients, successful localization of the lesion was obtained in 40 patients （93.0%） and failure of localization occurred in one patient （2.3%）. The time spent for the procedure varied from 8 min to 46 rain, with a mean of （17.19±6.64） rain. No statistically significant difference in localization accuracy existed between the two methods （P=0.179）. The time spent for the procedure in 1.5T MR-guided needle localization group was obviously longer than that in OAT fully-opened MR-guided needle localization group （P〈0.01）. Conclusion Both MR-guided bare-handed needle localization techniques for suspicious breast lesions have higher localization accuracy, and the time spent for the procedure is short. The lesions that are located at axillary region of breast and areola area, as well as at the special area near the chest wall can be precisely localized.