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目的:探讨应用全数字化乳腺钼铑靶摄影引导下导丝定位术对可疑恶性而临床不可触及病灶的手术切除应用价值。方法:采用美国GE公司乳腺Senographe 2000D型全数字化钼铑双靶乳腺X线机及数字化立体穿刺定位系统,对25例数字化钼铑靶乳腺X线片上可疑恶性而临床不可触及病灶的患者,在X线下导丝定位后进行手术切除,标本行全数字化X线摄片确定并快速进行病理组织学检查,明确诊断后采取不同手术方式治疗。结果:25例采用此方法病灶定位准确,病变完全切除,并明确诊断。病理结果显示8例为乳腺癌,1例非典型增生,16例良性病灶;1例行乳腺癌改良Ⅱ式根治术,2例行保乳手术,1例行保留乳头乳晕复合体的乳腺癌改良根治术+Ⅰ期乳房再造,5例全乳切除术,16例良性病灶行病灶局部切除术。结论:对X线钼铑靶提示恶性而临床又不能触及病灶行全数字化乳腺钼铑靶摄影穿刺定位术,达到手术入路短及精确切除病灶,保乳效果好,并能指导标本的病理诊断快速切片,对保乳、病灶的完全切除及病理诊断都有重要价值。
Objective: To explore the value of surgical resection of suspected non-palpable lesions with guiding guide wire under the guidance of fully digital breast molybdenum and rhodium target photography. Methods: A total of 25 cases of suspicious and malignant clinical non-palpable lesions on 25 cases of digitized molybdenum and rhodium target mammography were treated with the GE digital Mammography and Mammography scanner and the digitized stereotactic mapping system. Surgical removal of the guidewire after positioning, the specimen line to determine the full digital X-ray and rapid pathological examination, a clear diagnosis of different surgical treatment. Results: 25 cases using this method accurate positioning of the lesion, lesions completely removed, and a clear diagnosis. Pathological findings showed that 8 cases were breast cancer, 1 case of atypical hyperplasia and 16 cases of benign lesion. One case underwent modified radical mastectomy of breast cancer, two cases of breast conserving surgery and one case of modified breast cancer with reserved nipple-areola complex Radical mastectomy + stage Ⅰ breast reconstruction, 5 cases of mastectomy, 16 cases of benign lesions line local excision. Conclusion: The malignant X-ray molybdenum and rhodium targets and clinical lesions can not reach the line of digital mammography rhinorrhoeal target puncture positioning to achieve short surgical access and precise removal of lesions, breast-conserving effect, and can guide the pathological diagnosis of specimens Fast slicing, breast-conserving, complete removal of the lesion and pathological diagnosis has important value.