102例乳腺不可触及病变钼靶钩丝定位分析

Analysis of the Causes of the Location Deflection of Molybdenum Target Hook-wire in Clinical Non-palpable Breast Lesions

目的探讨钼靶钩丝定位偏移形成的原因及处理方法,提高定位精准性。方法回顾性分析102例乳腺触诊阴性病变患者乳腺钼靶X线三维立体定位系统引导下导丝定位结果,通过测量术中15°斜位片、自检位及术后标本导丝尖端与病变距离均<0.5 cm为定位精确,其中一项及以上≥0.5 cm为导丝偏移,分析导丝偏移的原因。结果102例乳腺触诊阴性病变(non-palpable breast lesions,NPBL)患者中,87例导丝尖端与病变距离<0.5 cm,精准度达到85%。15例导丝尖端与病变距离≥0.5 cm。造成导丝偏移的常见原因为定位过浅(4/15)、进针点选择不恰当(2/15)、进针手法不正确(6/15)、自检位偏离(3/15)。结论选择合适的进针部位、定位方式及正确的穿刺手法可明显提高定位的精准性。

Objective To explore the causes of the location deflection of molybdenum target hook-wire and the treatment methods,as to improve the positioning accuracy.Methods Retrospective analysis of 102 patients with negative breast palpation mammography mammography three-dimensional X-ray guided wire localization results,by measuring 15°oblique film in operation,self-check position and the distance between the tip of the guide wire and the lesion of the specimen after operation are all less than 0.5 cm,among which one or more≥0.5 cm is the guide wire deviation,the cause of the guide wire deviation is analyzed.Results In 102 patients with NPBL,the distance between the tip of the guide wire and the lesion was less than 0.5 cm,and the accuracy was 85%.The lesion was more than 0.5 cm in 15 cases.The common causes of guide wire deviation were shallow positioning(4/15),improper selection of needle feeding point(2/15),incorrect needle feeding technique(6/15),and deviation of self check guide wire(3/15).Conclusion Positioning method and correct puncture method to improve the accuracy of positioning and clinical resection.The accuracy of positioning can be improved obviously by selecting proper insertion site,positioning method and correct puncture technique.