| 李云,胡大卫,戚元刚,李云凌,李万湖.放射性粒子定位与金属丝定位引导切除隐匿性乳腺病变[J].中国医学影像技术,2019,35(2):214~217 |
| 放射性粒子定位与金属丝定位引导切除隐匿性乳腺病变 |
| Radioactive seed localization and wire-guided localization in excision of non-palpable breast lesions |
| 投稿时间：2018-05-12 修订日期：2018-09-14 |
| DOI：10.13929/j.1003-3289.201805070 |
| 中文关键词: 乳腺疾病 乳房X线摄影术 放射性粒子 金属丝 定位 |
| 英文关键词:breast diseases mammography radioactive seed wire localization |
| 基金项目:山东省医学科学院院级科学计划青年项目（2017-44）、山东省医学科学院院级科学计划面上项目（2017-09、2017-13）。 |
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| 中文摘要: |
| 目的 对比分析放射性粒子定位（RSL）与金属丝定位（WL）引导切除隐匿性乳腺病变的效果，探讨RSL的应用价值。方法 收集72例女性隐匿性乳腺病变患者，对其中34例行RSL（于术前5天内进行定位，RSL组）、38例行WL（于手术当日完成定位，WL组），而后均以手术切除病灶。对比2组定位准确率、首次切缘阴性率、病灶再切除率及定位相关并发症发生情况。结果 2组均定位准确，乳腺X线片示病灶均完整切除。RSL组首次切缘阴性率为91.18%（31/34），病灶再切除率为5.88%（2/34）；WL组分别为65.79%（25/38）和28.95%（11/38）；2组间差异均有统计学意义（P均<0.01）。WL组术中出现金属丝移位2例、迷走神经反应1例，RSL组未出现明显并发症。结论 RSL、WL均可准确定位并引导切除隐匿性乳腺病变；与WL比较，RSL不受手术时间影响，不易移位，切缘阴性率低，定位相关并发症少。 |
| 英文摘要: |
| Objective To compare the efficacy of radioactive seed localization (RSL) and wire-guided localization (WL) for intraoperative localization of non-palpable breast lesions, and to observe the application value of RSL. Methods Totally 72 women with non-palpable breast lesions who would underwent breast-conserving surgery were enrolled and divided into RSL group (n=34) and WL group (n=38). WL was performed at the same day as surgical excision, while RSL was performed within 5 days before the surgery. The precision rate of location, the rates of tumor-free margin and re-excision, as well as the localization-related complications were compared between the two groups. Results All lesions were precisely located and completely removed. The tumor-free margin rate and the re-excision rate of RSL was 91.18%(31/34) and 5.88%(2/34), while of WL was 65.79%(25/38) and 28.95%(11/38), respectively. There were significant differences between the two groups (both P<0.01). In WL group, 2 cases occurred wire shifting, 1 case had the vagus nerve response, while no localization-related complication occurred in RLS group. Conclusion Both RSL and WL can be used for accurate localization and guided-resection of non-palpable breast lesions. Compared with WL, positioning of RSL is not affected by operation time, which has higher tumor-free margin rate and lower re-excision rate. |
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