MRI引导下乳腺病灶导丝定位活检术的临床应用

The application of MRI guided breast localization and biopsy in breast lesions

目的探讨MRI引导下对仅MRI显示的乳腺病变导丝定位技术的可行性和临床应用价值。材料与方法收集在MRI引导下导丝定位手术切除活检病例127例共130个病灶。设备采用1.5 T MR扫描仪及特制的活检穿刺定位架。回顾性分析病灶的病理结果、影像学特征和定位的操作记录。结果定位切除活检恶性肿瘤53个(40.8%),高危病变(不典型导管增生)6个(4.6%),其他良性病变71个(54.6%)。恶性肿瘤包括21个(39.6%)浸润性癌、29个(54.7%)导管内癌、3个(5.7%)导管内乳头状癌。41个(31.5%)病灶表现为肿块,87个(66.9%)表现为非肿块强化,2个(1.5%)表现为点状强化。常规MRI测量病变长径为(16±11)mm。术前导丝定位操作时间为(24±8)min。2例(1.6%)发生血管迷走反应。结论对于仅MRI显示的乳腺可疑恶性病灶,MRI引导下导丝定位是一种安全、准确、快速的诊断方法,有助于乳腺癌的早期诊断和治疗。

Objective:MR imaging of the breast can depict cancer that is occult on conventional imaging modalities and at physical examination.The purpose of this study was to determine the ease of performance,the outcome of MRI-guided needle localization and the imaging features of breast lesion.Materials and Methods:Retrospective review revealed 130 consecutive breast lesions that had preoperative MR imaging-guided needle localization based on a 1.5 T MR scanner and a special MR biopsy positioning frame.Surgical pathology results,lesion characteristics,procedure record were reviewed.Results:Histologic evaluation revealed 53(40.8%)carcinomas,6(4.6%)high-risk lesions(atypical ductal hyperplasia),and 71(54.6%)benign lesions.Twenty one(39.6%)of 53 carcinomas were invasive carcinoma,29(54.7%)were ductal carcinoma in situ,and 3(5.7%)were intraductal papillary carcinoma.Of the 1301 esions,41(31.5%)were masses,87(66.9%)were non-mass enhancement lesions,two(1.5%)were foci.Mean lesion size evaluated by MRI prior to needle localization was(16±11)mm.The mean length of the interventional procedure time defined as the time interval between the start of the first and of the last MRI sequence was(24±8)minutes.Compliclations encountered in two cases(1.6%)were vasovagal reactions.Conclusions:MRI guided needle localization provides a safe,accurate and time-efficient procedure for localizing the suspicious lesions detected on MRI only and can be applied to improve early diagnosis and treatment.