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目的探讨数字化钼靶X线引导下三维立体导丝定位穿刺术对NPBLs的诊断价值及意义。方法对53例NPBLs患者、据乳腺影像报告系统(BI-RADS)分类为BI-RADS 4~5类及部分3类因顾虑过多自己要求活检的患者,采用X线引导下三维导丝立体穿刺定位,术后行病理学检查的临床资料进行回顾性分析。结果 53例患者中诊断为BI-RADS 4类39例,其中4a类9例,4b类12例,4c类18例,BI-RADS 5类9例,BI-RADS 3类因患者顾虑过多强烈要求活检5例,所有患者均一次性定位成功,病变完全切除,术后病理结果示:恶性病变32例(60.3%),其中浸润性导管癌16例(30.0%),导管内原位癌11例(21.0%),小叶原位癌4例(7.0%),黏液腺癌1例(1.0%);良性病变21例(39.7%),其中乳腺纤维腺瘤10例(19.0%),乳腺腺病5例(9.0%),非典型增生3例(6.0%),乳腺囊肿2例(4.0%),导管内乳头状瘤1例(1.0%)。结论乳腺数字化三维立体导丝定位穿刺术操作方法简单、安全性高、定位准确,在病灶切除完全的同时,切除组织少,同时,对NPBLs的诊断与治疗具有十分重要的价值。
Objective To investigate the diagnostic value and significance of three-dimensional guided wire positioning and puncturing guided by digital mammography to NPBLs. Methods 53 patients with NPBLs were classified into 4 types and 5 types of BI-RADS according to the Breast Imaging Report System (BI-RADS), and some 3 patients were asked for biopsy because of their concerns. Location, postoperative pathological examination of clinical data for retrospective analysis. Results Among 53 patients, 39 cases were diagnosed as BI-RADS type 4, including 9 cases of category 4a, 12 cases of category 4b, 18 cases of category 4c, 9 cases of category BI-RADS and 9 cases of category BI-RADS. Biopsy was required in 5 cases. All the patients were successfully located at one time, and the lesions were completely removed. The pathological results showed that 32 cases (60.3%) had malignant lesions, including 16 invasive ductal carcinomas (30.0%), (21.0%), lobular carcinoma in situ in 4 cases (7.0%), mucinous adenocarcinoma in 1 case (1.0%), benign lesions in 21 cases (39.7%), including 10 cases of breast fibroadenoma (19.0% Five patients (9.0%), three patients with atypical hyperplasia (6.0%), two patients with breast cyst (4.0%) and one patient (1.0%) had intraductal papilloma. Conclusions The operation method of digitalized three-dimensional guide wire positioning and puncturing of breast is simple, safe and accurate in positioning. It is of great value in the diagnosis and treatment of NPBLs when the lesion is completely resected and the number of resected tissues is small.