超声引导下置入定位针联合体表标记在乳腺小肿物切除术中的应用

摘要

目的探讨超声引导下对乳腺小病灶内置入定位针联合体表投影标记法（双定位）在乳腺小病灶切除术中的临床应用价值。方法超声引导下将定位针置入直径小于2．0 cm，临床不能扪及或位置过深的良性或可疑恶性（依据北美放射学会乳腺影像和报告数据系统诊断为BI－RADS 3级或4级）乳腺小病灶内，同时在乳腺体表皮肤勾画标记行双重定位，以辅助术中快速寻找并完整切除病灶。结果术前在超声引导下对51例54个显示为低回声的乳腺病灶内置入定位针，病灶大小0．4～2．7 cm，平均（1．2±0．4）cm；病灶表面与皮肤垂直距离（深度）为0．3～1．9 cm，平均（0．8±0．4）cm。术中沿定位针切开皮肤和皮下组织快速完整切除了病变组织。手术后病理证实51例54个乳腺实性低回声病灶中良性病变46例（纤维囊性乳腺病22例，纤维腺瘤11例，导管内乳头状瘤10例，炎性病变2例，硬化性腺病1例）；恶性病变5例（浸润性导管癌2例，导管内癌2例，黏液癌1例）；不典型增生3例。结论超声引导下穿刺置入定位针联合体表投影标记法有助于临床医师快速准确切除不能扪及的乳腺小病灶。%Objective To evaluate the application of ultrasound-guided wire localization of lesions combining with body mark for non-palpable breast lesions in surgical excision .Methods Under ultrasound guidance,needles were placed in small or deep location non-palpable lesions found by ultrasound (BI-RADS 3 or 4).At the same time body mark were made on the skin before surgery.Results Fifty-four hypo-echoic lesions were placed wire needles guided by ultrasound.The mean diameter was 1.2 ±0.4 cm(range 0.4-2.7 cm).The mean depth was 0.8 ±0.4 cm(range 0.3-1.9 cm).All these lesions were resected completely and quickly . For the 54 solid lesions,histology results included 5 malignant lesions (2 infiltrating ductal carcinoma,2 intraductal carcinoma and 1 carcinoma mucosum),3 atypical hyperplasia lesions and 46 benign lesions(22 fibroadenosis,11 fibroadenomas, 10 intraductal papilomas, 2 inflammation and 1 sclerosing adenosis ). Conclusion Ultrasound-guided wire localization combing with body mark for non-palpable breast lesions is helpful for accurate resection of the non-palpable breast lesions.