高频超声引导下导丝定位在不可触及乳腺包块切除术中的应用
|
摘要
目的:探讨高频超声引导下导丝定位在不可触及乳腺包块切除术中的应用价值。方法:回顾性分析90例临床不可触及但超声提示为乳腺包块的患者的临床资料,其中50例在高频超声引导乳腺病灶体表定位下行乳腺病灶切除术,40例在高频超声引导导丝定位下行乳腺病灶切除术。比较两组术前定位时间、手术时间、切除组织量/肿物组织量及术后并发症的发生情况、术后病理诊断及术后超声随访情况。结果:与体表定位组比较,导丝定位组定位时间显著延长(P<0.05),手术时间明显缩短(P<0.05),切除组织量/肿物组织量显著减小(P<0.05)。体表定位组出现2例切口感染,5例血肿,两组不良反应的发生率相比差异无统计学意义(P>0.05)。体表定位组良性48例(96.0%),恶性病灶2例(4.0%)。导丝定位组良性病灶36例(90.0%),恶性病灶4例(10.0%)。两组病理诊断为良/恶病灶的比例无统计学意义(P>0.05)。术后超声随访6~12个月,病灶切除情况比较差异无统计学意义(P>0.05)。结论:高频超声引导下导丝定位精确,可明显缩短手术时间,减少对正常乳腺组织的破坏,可作为行不可触及乳腺包块切除术的优先选择。
Objective: To investigate the application value of high frequency ultrasound guided wire localization for the non palpable breast mass resection. Methods: The clinical data of 90 cases of patients with palpable breast masses were retrospectively analyzed,50 cases were under surface positioning of breast lesions guided by high frequency ultrasound, and 40 cases were under wire positioning of breast lesions guided of high frequency ultrasound. The preoperative positioning time, operation time, the amount of resected tissue dose/tumor dose, postoperative complications, postoperative pathological diagnosis and postoperative follow-up were compared between the two groups. Results: Compared with the surface positioning group, the positioning time of positioning group was significantly extended(P<0.05), and operation time was shortened(P<0.05), the resected tissue dose/tumor dose was reduced(P<0.05) and incidence of complications showed no statistically significant difference between two groups(P>0.05). 48 cases(96%) was optimum in surface location group, and 2 cases(4%) was malignant lesions. There were 36 cases of benign lesions in the wirepositioning group(90%), and 4 cases of malignant lesions(10%). The pathological diagnosis of benign lesions/cachexia ratio of two groups showed no statistically significant difference(P>0.05). The patients were followed up for 6~12 months after operation, and there was no significant difference in the lesions resection between the two groups(P>0.05). Conclusion: High frequency ultrasound guided wire localization showed high accuracy, which can significantly shoren the operation time, reduce the damage to normal breast tissue.It was an excellent choice for non palpable breast mass resection.
Objective: To investigate the application value of high frequency ultrasound guided wire localization for the non palpable breast mass resection. Methods: The clinical data of 90 cases of patients with palpable breast masses were retrospectively analyzed,50 cases were under surface positioning of breast lesions guided by high frequency ultrasound, and 40 cases were under wire positioning of breast lesions guided of high frequency ultrasound. The preoperative positioning time, operation time, the amount of resected tissue dose/tumor dose, postoperative complications, postoperative pathological diagnosis and postoperative follow-up were compared between the two groups. Results: Compared with the surface positioning group, the positioning time of positioning group was significantly extended(P<0.05), and operation time was shortened(P<0.05), the resected tissue dose/tumor dose was reduced(P<0.05) and incidence of complications showed no statistically significant difference between two groups(P>0.05). 48 cases(96%) was optimum in surface location group, and 2 cases(4%) was malignant lesions. There were 36 cases of benign lesions in the wirepositioning group(90%), and 4 cases of malignant lesions(10%). The pathological diagnosis of benign lesions/cachexia ratio of two groups showed no statistically significant difference(P>0.05). The patients were followed up for 6~12 months after operation, and there was no significant difference in the lesions resection between the two groups(P>0.05). Conclusion: High frequency ultrasound guided wire localization showed high accuracy, which can significantly shoren the operation time, reduce the damage to normal breast tissue.It was an excellent choice for non palpable breast mass resection.
引文
[1]Park HL,Kim LS.The current role of vacuum assistedbreast biopsy system in breast disease[J].J Breast Canc-er,2011,14(1):1-7
[2]Albino RL,Guimares SE,Daniels KM,et al.Technical note:Mammary gland ultrasonography to evaluate mammary parenchymal composition in prepubertal heifers[J].Journal of Dairy Science,2016,100(2):1588-1591
[3]Lima JA,Ruas JR,Vasconcelos AC,et al.Effects of bovine mammary gland biopsy and increased milking frequency on post-procedure udder health,histology,and milk yield[J].Animal,2016,10(5):1-9
[4]Yamazaki Y,Takahashi E,Iwata M,et al.Mammary gland segmentation using intensity correction for brightness attenuation in breast ultrasound image[C].IEEE International Conference on Imaging Systems and Techniques.IEEE,2016:498-503
[5]Acharya UR,Chowriappa P,Fujita H,et al.Thyroid lesion classification in 242 patient population using Gabor transform features from high resolution ultrasound images[J].Knowledge-Based Systems,2016,107(3):235-245
[6]Fillion MM,Black EA,Hudson KB,et al.The effect ofmultiple wire localization in breast conservation[J].Am Surg,2012,78(5):519-522
[7]Koundal D,Gupta S,Singh S.Automated delineation of thyroid nodules in ultrasound images using spatial neutrosophic clustering and level set[M].Elsevier Science Publishers B.V.2016
[8]Kaliszewski K,Zubkiewicz-Kucharska A,Wojtczak B,et al.Ultrasound Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules:Does Radiologist Assistance Decrease the Rate of Unsatisfactory Biopsies[J].Advances in Clinical&Experimental Medicine Official Organ Wroclaw Medical University,2016,25(1):93
[9]Sajid MS,Parampalli U,Haider Z,et al.Comparison of radioguided occult lesion localization(ROLL)and wire localization for non-palpable breast cancers:A meta-analysis[J].J Surg Oncol,2011,105(8):852-858
[10]Choo KS,Kwak HS,Tae BY,et al.The value of a combination of wire localization and ultrasound-guided vacuum-assisted breast biopsy for clustered microcalcifications[J].Breast,2014,17(6):611-616
[11]Na DG,Kim JH,Kim DS,et al.Thyroid nodules with minimal cystic changes have a low risk of malignancy[J].Ultrasonography,2016,35(2):153-158
[12]Choi SH,Baek JH,Ha EJ,et al.Diagnosis of Metastasis to the Thyroid Gland:Comparison of Core-Needle Biopsy and Fine-Needle Aspiration[J].Otolaryngology Head&Neck Surgery,2016,154(4):32-35
[13]English C,Casey R,Bell M,et al.The Sonographic Features of the Thyroid Gland After Treatment with Radioiodine Therapy in Patients with Graves'Disease[J].Ultrasound in Medicine&Biology,2016,42(1):60-67
[14]Alves ML,Gabarra MH.Comparison of power Doppler and thermography for the selection of thyroid nodules in which fine-needle aspiration biopsy is indicated[J].Radiologia Brasileira,2016,49(5):311
[15]Nam S J,Yoo J,Lee HS,et al.Quantitative Evaluation for Differentiating Malignant and Benign Thyroid Nodules Using Histogram Analysis of Grayscale Sonograms[J].Journal of Ultrasound in Medicine Official Journal of the American Institute of Ultrasound in Medicine,2016,35(4):41
[16]Franz AM,Seitel A,Bopp N,et al.First clinical use of the Echo Track guidance approach for radiofrequency ablation of thyroid gland nodules[J].International Journal of Computer Assisted Radiology&Surgery,2017,39(5):1-10
[17]Di FM,Della PA,Salvatorelli A,et al.A single thyroid nodule revealing early metastases from clear cell renal carcinoma:case report and review of literature[J].International Journal of Surgery Case Reports,2017,34(5):96-99
[18]Morita K,Sakamoto T,Ota S,et al.Ultrasound findings of diffuse metastasis of gastric signet-ring-cell carcinoma to the thyroid gland[J].Journal of Medical Ultrasonics,2016,44(1):1-7
[19]Palaniappan MK,Aiyappan SK,Ranga U.Role of Gray Scale,Color Doppler and Spectral Doppler in Differentiation Between Malignant and Benign Thyroid Nodules[J].Journal of Clinical&Diagnostic Research Jcdr,2016,10(8):TC01-TC06
[20]Song YS,Kim JH,Na DG,et al.Ultrasonographic Differentiation Between Nodular Hyperplasia and Neoplastic Follicular-Patterned Lesions of the Thyroid Gland[J].Ultrasound in Medicine&Biology,2016,42(8):1816-1824
[21]De Koster EJ,Kist JW,Vriens MR,et al.Thyroid Ultrasound-Guided Fine-Needle Aspiration:The Positive Influence of On-Site Adequacy Assessment and Number of Needle Passes on Diagnostic Cytology Rate[J].Acta Cytologica,2016,60(2):35
[22]Tating DL,Montevirgen ND,Cajucom L.Cushing's Syndrome From Pituitary Microadenoma and Pulmonary Nodules[J].Oncology Nursing Forum,2016,43(2):136-140
[23]Sternlieb S J,Satija C,Jr PD,et al.Management dilemma of thyroid nodules in patients with malignant struma ovarii[J].Gland Surgery,2016,5(4):431
[24]He LZ,Zeng TS,Pu L,et al.Thyroid Hormones,Autoantibodies,Ultrasonography,and Clinical Parameters for Predicting Thyroid Cancer[J].International Journal of Endocrinology,2016,2016(3):1-11
[25]Lee SJ,Lim GY,Kim JY,et al.Diagnostic performance of thyroid ultrasonography screening in pediatric patients with a hypothyroid,hyperthyroid or euthyroid goiter[J].Pediatric Radiology,2016,46(1):1-8
[26]Hammad AY,Noureldine SI,Hu T,et al.A meta-analysis examining the independent association between thyroid nodule size and malignancy[J].Gland Surgery,2016,5(3):312
[27]Khadra H,Bakeer M,Hauch A,et al.Is vascular flow a predictor of malignant thyroid nodules A meta-analysis[J].Gland Surgery,2016,5(6):576
[28]Jiang C,Jin S,Jiang Z,et al.Inhibitory effects of silibinin on proliferation and lung metastasis of human high metastasis cell line of salivary gland adenoid cystic carcinoma via autophagy induction[J].Oncotargets&Therapy,2016,9(3):6609-6618
[29]Rahal A,Falsarella PM,Rocha RD,et al.Correlation of Thyroid Imaging Reporting and Data System[TI-RADS]and fine needle aspiration:experience in 1,000 nodules[J].Einstein,2016,14(2):119-123
[30]Tucker DK,Foley JF,Hayes-Bouknight SA,et al.Preparation of High-quality Hematoxylin and Eosin-stained Sections from Rodent Mammary Gland Whole Mounts for Histopathologic Review[J].Toxicologic Pathology,2016,44(7):46
[2]Albino RL,Guimares SE,Daniels KM,et al.Technical note:Mammary gland ultrasonography to evaluate mammary parenchymal composition in prepubertal heifers[J].Journal of Dairy Science,2016,100(2):1588-1591
[3]Lima JA,Ruas JR,Vasconcelos AC,et al.Effects of bovine mammary gland biopsy and increased milking frequency on post-procedure udder health,histology,and milk yield[J].Animal,2016,10(5):1-9
[4]Yamazaki Y,Takahashi E,Iwata M,et al.Mammary gland segmentation using intensity correction for brightness attenuation in breast ultrasound image[C].IEEE International Conference on Imaging Systems and Techniques.IEEE,2016:498-503
[5]Acharya UR,Chowriappa P,Fujita H,et al.Thyroid lesion classification in 242 patient population using Gabor transform features from high resolution ultrasound images[J].Knowledge-Based Systems,2016,107(3):235-245
[6]Fillion MM,Black EA,Hudson KB,et al.The effect ofmultiple wire localization in breast conservation[J].Am Surg,2012,78(5):519-522
[7]Koundal D,Gupta S,Singh S.Automated delineation of thyroid nodules in ultrasound images using spatial neutrosophic clustering and level set[M].Elsevier Science Publishers B.V.2016
[8]Kaliszewski K,Zubkiewicz-Kucharska A,Wojtczak B,et al.Ultrasound Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules:Does Radiologist Assistance Decrease the Rate of Unsatisfactory Biopsies[J].Advances in Clinical&Experimental Medicine Official Organ Wroclaw Medical University,2016,25(1):93
[9]Sajid MS,Parampalli U,Haider Z,et al.Comparison of radioguided occult lesion localization(ROLL)and wire localization for non-palpable breast cancers:A meta-analysis[J].J Surg Oncol,2011,105(8):852-858
[10]Choo KS,Kwak HS,Tae BY,et al.The value of a combination of wire localization and ultrasound-guided vacuum-assisted breast biopsy for clustered microcalcifications[J].Breast,2014,17(6):611-616
[11]Na DG,Kim JH,Kim DS,et al.Thyroid nodules with minimal cystic changes have a low risk of malignancy[J].Ultrasonography,2016,35(2):153-158
[12]Choi SH,Baek JH,Ha EJ,et al.Diagnosis of Metastasis to the Thyroid Gland:Comparison of Core-Needle Biopsy and Fine-Needle Aspiration[J].Otolaryngology Head&Neck Surgery,2016,154(4):32-35
[13]English C,Casey R,Bell M,et al.The Sonographic Features of the Thyroid Gland After Treatment with Radioiodine Therapy in Patients with Graves'Disease[J].Ultrasound in Medicine&Biology,2016,42(1):60-67
[14]Alves ML,Gabarra MH.Comparison of power Doppler and thermography for the selection of thyroid nodules in which fine-needle aspiration biopsy is indicated[J].Radiologia Brasileira,2016,49(5):311
[15]Nam S J,Yoo J,Lee HS,et al.Quantitative Evaluation for Differentiating Malignant and Benign Thyroid Nodules Using Histogram Analysis of Grayscale Sonograms[J].Journal of Ultrasound in Medicine Official Journal of the American Institute of Ultrasound in Medicine,2016,35(4):41
[16]Franz AM,Seitel A,Bopp N,et al.First clinical use of the Echo Track guidance approach for radiofrequency ablation of thyroid gland nodules[J].International Journal of Computer Assisted Radiology&Surgery,2017,39(5):1-10
[17]Di FM,Della PA,Salvatorelli A,et al.A single thyroid nodule revealing early metastases from clear cell renal carcinoma:case report and review of literature[J].International Journal of Surgery Case Reports,2017,34(5):96-99
[18]Morita K,Sakamoto T,Ota S,et al.Ultrasound findings of diffuse metastasis of gastric signet-ring-cell carcinoma to the thyroid gland[J].Journal of Medical Ultrasonics,2016,44(1):1-7
[19]Palaniappan MK,Aiyappan SK,Ranga U.Role of Gray Scale,Color Doppler and Spectral Doppler in Differentiation Between Malignant and Benign Thyroid Nodules[J].Journal of Clinical&Diagnostic Research Jcdr,2016,10(8):TC01-TC06
[20]Song YS,Kim JH,Na DG,et al.Ultrasonographic Differentiation Between Nodular Hyperplasia and Neoplastic Follicular-Patterned Lesions of the Thyroid Gland[J].Ultrasound in Medicine&Biology,2016,42(8):1816-1824
[21]De Koster EJ,Kist JW,Vriens MR,et al.Thyroid Ultrasound-Guided Fine-Needle Aspiration:The Positive Influence of On-Site Adequacy Assessment and Number of Needle Passes on Diagnostic Cytology Rate[J].Acta Cytologica,2016,60(2):35
[22]Tating DL,Montevirgen ND,Cajucom L.Cushing's Syndrome From Pituitary Microadenoma and Pulmonary Nodules[J].Oncology Nursing Forum,2016,43(2):136-140
[23]Sternlieb S J,Satija C,Jr PD,et al.Management dilemma of thyroid nodules in patients with malignant struma ovarii[J].Gland Surgery,2016,5(4):431
[24]He LZ,Zeng TS,Pu L,et al.Thyroid Hormones,Autoantibodies,Ultrasonography,and Clinical Parameters for Predicting Thyroid Cancer[J].International Journal of Endocrinology,2016,2016(3):1-11
[25]Lee SJ,Lim GY,Kim JY,et al.Diagnostic performance of thyroid ultrasonography screening in pediatric patients with a hypothyroid,hyperthyroid or euthyroid goiter[J].Pediatric Radiology,2016,46(1):1-8
[26]Hammad AY,Noureldine SI,Hu T,et al.A meta-analysis examining the independent association between thyroid nodule size and malignancy[J].Gland Surgery,2016,5(3):312
[27]Khadra H,Bakeer M,Hauch A,et al.Is vascular flow a predictor of malignant thyroid nodules A meta-analysis[J].Gland Surgery,2016,5(6):576
[28]Jiang C,Jin S,Jiang Z,et al.Inhibitory effects of silibinin on proliferation and lung metastasis of human high metastasis cell line of salivary gland adenoid cystic carcinoma via autophagy induction[J].Oncotargets&Therapy,2016,9(3):6609-6618
[29]Rahal A,Falsarella PM,Rocha RD,et al.Correlation of Thyroid Imaging Reporting and Data System[TI-RADS]and fine needle aspiration:experience in 1,000 nodules[J].Einstein,2016,14(2):119-123
[30]Tucker DK,Foley JF,Hayes-Bouknight SA,et al.Preparation of High-quality Hematoxylin and Eosin-stained Sections from Rodent Mammary Gland Whole Mounts for Histopathologic Review[J].Toxicologic Pathology,2016,44(7):46