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目的探讨数字化立体定位导丝导向活检(SNLB),对临床不可触及乳腺病变(NPBL)的诊断及临床应用价值。方法对95例临床触诊阴性,而数字钼钨双靶乳腺摄片发现异常的病灶,进行了SNLB切除活检。结果数字化乳腺摄片表现为:簇状微小钙化49例,孤立性结节27例,局限致密或结构紊乱15例,放射状毛刺影4例。SNLB活检组织标本病理结果中良性病变67例,恶性病变28例,其中包括导管原位癌14例。结论 SNLB对临床不可触及病变,定位定性诊断准确、安全,有利于早期发现乳腺癌。 相似文献
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全数字化乳腺X线引导下钙化灶导丝定位活检对早期乳腺癌诊断的意义 总被引:1,自引:0,他引:1
目的探讨在全数字化乳腺X线引导下的钙化灶术前定位及活检对早期乳腺癌的诊断价值及意义。方法对211例乳腺微小钙化且临床不能触及肿块、超声阴性的患者行数字化乳腺X线引导下乳腺钙化灶导丝定位,然后在手术室全麻下进行病灶活检。结果 211例患者中,乳腺恶性病变62例(29.4%),良性病变149例(70.6%);≤40岁患者的恶性病变发生率占该年龄段患者的12.5%,>40岁患者的恶性病变发生率占该年龄段患者的34.4%,比较差异有统计学意义(P<0.01)。结论对于临床不可触及而通过全数字化乳腺X线摄影筛查发现的可疑微小钙化灶,特别是年龄>40岁的成簇钙化患者,应该积极在乳腺X线引导下导丝穿刺定位,行乳腺钙化灶活检;该方法定位准确,切除完整,术中腺体损伤小。 相似文献
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乳腺断层摄影是通过多点投照获得多个层面的重建图像,这种技术能够提高病灶的检出率和诊断的准确性,降低筛查回叫率。在乳腺疾病的诊断与乳腺癌的筛查中均起着重要作用。双能量乳腺增强摄影检查时需给患者注入碘造影剂,并通过高低能量两次曝光获得标准能量图和高低能量减影图,后者能显示有异常的强化区域。这种技术仅用于诊断性检查,跟常规的乳腺X线检查或常规X线检查加超声组合相比,其检出乳腺癌的敏感性更高;与增强乳腺MRI相比,对主病灶判断的特异性较高,敏感性则相当。 相似文献
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目的 对钼靶X线发现钙化灶但不能触及肿块的乳腺病变进行诊断。方法 对26例钼靶X线片显示有恶性可能的钙化灶而临床不能触及肿块的患者,术前在放射科钼靶X线引导下行乳腺细导丝定位,然后在局麻下行乳腺活检。结果 26例采用此方法活检者均成功取出病变组织,并明确诊断。病理结果为乳腺纤维腺瘤4例,乳腺囊性增生10例,乳腺乳头状瘤3例,积乳囊肿1例,导管内癌5例,浸润性导管癌3例。结论 钼靶X线导丝定位下活检,对X线片显示有恶性可能的钙化灶而临床不能触及肿块,可增加活检的准确性,是一种安全有效的诊断方法,对乳腺癌的早期诊断有一定的意义。 相似文献
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目的:探讨乳腺 X线立体定位导丝引导开放切除活检在触诊阴性乳腺钙化病变诊治中的应用价值。 方法:回顾性分析自 2017年 9月至 2021年 7月在我院就诊的临床查体阴性而乳腺 X线检查 BI RADS分级为 4~5 级的可疑钙化病变患者资料,患者分为两组,分别接受体表定位法和乳腺 X线立体定位导丝引导进行乳腺钙化病变 开放手术切除活检,比较两组定位的准确性和保乳率。结果:共 131例钙化患者接受了开放手术切除活检,双侧均有 钙化病变者 7例,最终 138个病灶进行分析。22个病灶采用体表定位标记后开放切除活检,术中二次扩大切除率为 9.1%(2/22),保乳率为 42.9%(3/7)。116个病灶采用乳腺 X线立体定位导丝引导开放切除活检,术中二次扩大切 除率为 1.7%(2/116),保乳率为 52.9%(9/17)。结论:乳腺 X线立体定位引导下的导丝穿刺,可精准定位可疑钙化 病变,准确切除,避免二次扩大切除,提高保乳率,是适合在基层医院进行推广的一种诊断和治疗手段。 相似文献
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目的 探讨数字乳腺断层融合X线成像技术(DBT)在乳腺癌早期诊断中的应用价值.方法 对150例临床检查可疑、乳腺超声诊断报告和数据系统(BI-RADS)0级或≥3级的病例,分别行乳腺X线摄影(DM)检查和DBT检查,并独立诊断.以病理诊断结果 为金标准,比较DM和DBT对早期乳腺癌及致密型乳腺癌的诊断效能.结果以病理诊断结果为金标准,DBT与DM诊断早期乳腺癌的灵敏度分别为86.6%和74.2%,特异度分别为96.2%和81.1%,准确度分别为90.0%和76.7%,DBT对早期乳腺癌的诊断效能优于DM,差异均有统计学意义(P﹤0.05).以病理诊断结果为金标准,DBT与DM对致密型乳腺癌诊断的灵敏度分别为94.6%和70.3%,特异度分别为92.9%和64.3%,准确度分别为93.8%和67.7%,DBT对致密型乳腺癌的诊断效能优于DM,差异均有统计学意义(P﹤0.05).结论 DBT能提高早期乳腺癌尤其是致密型乳腺癌的检出率,诊断效能优于DM. 相似文献
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目的 探讨乳腺数字钼靶X线摄影的摆位对图像质量的影响.方法 收集1000例女性患者的4 000幅乳腺数字钼靶X线图像,均为双侧乳腺头尾位(CC位)及内外侧斜位(MLO位)所摄,由1位副主任医师和2位主管技师对上述图像资料进行质量分析,计算甲级片和非甲级片率,并对非甲级片产生的原因进行分析.结果 甲级片3 730幅,非甲... 相似文献
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《Asian Pacific journal of cancer prevention》2014,15(13):5171-5174
Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson’s Chi-square, continuity correction, and Fisher’s exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55). Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures. 相似文献
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Youn Joo Jung Young Tae Bae Jee Yeon Lee Hyung-Il Seo Jee Yeon Kim Ki Seok Choo 《JOURNAL OF BREAST CANCER》2011,14(1):64-68
Stereotactic vacuum-assisted breast biopsy (VAB) has been used to evaluate microcalcifications or non-palpable breast lesions on mammography. Although stereotactic VAB is usually performed in a prone or upright position, an expensive prone table is necessary and vasovagal reactions often occur during the procedure. For these reasons, the lateral decubitus position can be applied for stereotactic VAB, and true lateral mammography can be used to detect the lesion. We report on 15 cases of lateral decubitus positioning for stereotactic VAB with true lateral mammography for non-palpable breast lesions or microcalcifications. The mean procedure time was approximately 30.1 minutes, and no complications occurred during the procedures. Fourteen cases had benign breast lesions and one case had a ductal carcinoma in situ. The lateral decubitus stereotactic VAB with true lateral mammography can be applied for microcalcifications or non-palpable breast lesions and helps to minimize anxiety and vasovagal reactions in patients. 相似文献
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Wire-guided Localization Biopsy to Determine Surgical Margin Status in Patients with Non-palpable Suspicious Breast Lesions 下载免费PDF全文
《Asian Pacific journal of cancer prevention》2012,13(10):4989-4992
Purpose: Guide-wire localization (GWL) has been a standard technique for many years. Excision of nonpalpablemalignant breast lesions with clear surgical margins reduces the risk of undergoing re-excision. Theobjective of the present study was to evaluate the efficacy of GWL biopsy for assessing surgical margins. Methods:This retrospective study concerned 53 patients who underwent GWL biopsy for non-palpable breast lesionsand breast carcinoma diagnosed by histological examination. Age of the patients, tumour size, radiographicfindings, breast density specifications, specimen volumes, menopausal status and family history of the patientsand surgical margin status were recorded. Results: Median age was 53.3 years, median tumour size was 1.5 cmand median specimen volume was 71.5 cm3. In fifteen patients (28%) DCIS and in 38 patients (72%) invasiveductal carcinoma was diagnosed. There was positive surgical margins in twenty eight (52.8%) patients. Themedian distance to the nearest surgical margin was 7.2 mm in clear surgical margins. Younger age and denserbreast specifications were found as statistically significant factors for surgical margin status. Median age of thepatients who had positive margins was 49.4 years where it was 56.9 years in the patients with negative margins(p=0.04). 79% of the patients with positive margins had type 3-4 pattern breast density according to BIRADSclassification as compared to 48% in the patients who had negative margins (p=0.03). Some 38 patients whohad positive or close surgical margins received re-excision (72%). Conclusion: Positive margin rates may behigher because of inherent biological differences and diffuse growth patterns in younger patients. There are alsotechnical difficulties that are relevant to denser fibroglandular tissue in placing hooked wire. High re-excisionrates must be taken into consideration while performing GWL biopsy in non-palpable breast lesions. 相似文献
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[目的]探讨乳腺X线立体定位穿刺活检技术对乳腺微小病变(NPBL)的诊断价值。[方法]采用美国GE钼铑双靶X线机及数字化三维立体定位穿刺活检系统对40例临床不可触及的NPBL患者先行立体定位穿刺活检(SCNB),再行立体定位细针引导切检(SNLB),比较SCNB与SNLB的病理检查结果。[结果]40例NPBL患者,均进行了SCNB和SNLB技术处理,无一例发生并发症。SCNB诊断准确率为95%(38/40),诊断早期乳腺癌的敏感度为84.6%(11/13),特异性为100.0%(27/27)。[结论]SCNB技术创伤小,操作简便,既可提高早期乳腺癌的诊断率,又避免了良性病变手术活检的痛苦,值得临床应用。 相似文献
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乳腺微小钙化定位切除的临床应用 总被引:1,自引:0,他引:1
目的 探讨乳腺微小钙化定位切除手术的应用及在乳腺癌早期诊断和治疗中的作用.方法 对126例乳腺微小钙化患者行X线检查确定钙化灶位置,采用金属线定位和手术切除活检,确定钙化区乳腺的病理类型.结果 126例临床触诊阴性乳腺微小钙化病例中,乳腺癌37例(27.2%),其中0期乳腺癌11例(29.7%),Ⅰ期乳腺癌20例(54.1%),Ⅱ期乳腺癌6例(16.2%).对乳腺癌病例采用保乳手术、乳腺单纯切除术和改良根治术等治疗,术后中位随访时间为36个月,只有1例(2.7%)Ⅱ期乳腺癌患者出现远处转移,其余患者无瘤生存.结论 乳腺微小钙化定位切除具有组织损伤小,可靠性高等特点,对提高乳腺癌的早期诊断率具有一定的临床应用价值. 相似文献
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J. B. Jameson 《Journal of Medical Imaging and Radiation Oncology》1970,14(1):40-45
A technique is described for aspiration biopsy of localized intrathoracic lesions, using a standard 18-gauge needle and television fluoroscopy. It is based on the method of Dahlgren and Nordenström, but incorporates an important modification to verify correct placement of the needle. The indications, contraindications and complications are discussed and the results of 50 such investigations are presented. 相似文献