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探讨乳腺全容积成像系统(automated breast volume scanner,ABVS)联合乳腺真空辅助活检在隐匿性乳腺病变诊治中的临床应用价值。方法:2010-01-2012-12寿光市妇幼保健院外科对87例105个乳腺隐匿性病灶在ABVS引导下进行乳腺真空辅助活检微创旋切术,通过病理检查和随访,评价乳腺形态、边界、微小钙化和纵横比等4个方面ABVS影像特征对临床诊断的指导意义,以及联合乳腺真空辅助活检系统在乳腺隐匿性病变中的诊疗价值。结果:105个病灶中根据有无发现低回声结节分为两组。一组通过ABVS诊断为低回声结节乳腺病灶91个,其中BI-RADS分级Ⅱ级38个,包括普通增生病变14个,乳腺纤维瘤15个,乳腺导管内乳头状瘤3个,重度非典型增生5个,原位癌1个;BI-RADS分级Ⅲ级53个,包括普通增生病变4个,乳腺纤维瘤28个,乳腺导管内乳头状瘤9个,重度非典型增生8个,原位癌2个,浸润性导管癌2个。另一组14例ABVS检查仅结构紊乱但是有乳腺癌家族史、年龄≥40岁,有6个月以上乳腺疼痛病史,14个病灶均为BI-RADS分级Ⅰ级,其中普通增生11个,重度非典型增生2个,原位癌1个。术后血肿发生率为8.0%(7/87),痊愈率为97.7%(85/87),病灶残留发生率为2.3%(2/87)。结论:ABVS能够及时发现乳腺隐匿性病变,结合真空辅助活检微创能够尽早进行乳腺隐匿性病变的定性诊断,两者联合应用尤其适用于没有X射线钼靶检查手段的基层医院。
To investigate the clinical value of automated breast volume scanner (ABVS) combined with breast vacuum assisted biopsy in the diagnosis and treatment of occult breast lesions. METHODS: From October 2010 to December 2012, 87 cases of 105 masculine lesions of the breast were treated with minimally invasive breast biopsy assisted biopsy under the guidance of ABVS. The pathological examination and follow-up were performed to evaluate the breast morphology and borderline , Microcalcification and aspect ratio, etc. The diagnostic value of ABVS features in clinical diagnosis and the diagnostic value of combined breast vacuum assisted biopsy in occult breast disease. Results: 105 lesions were divided into two groups based on the presence or absence of hypoechoic nodules. A group of 91 patients with low-echo nodular breast lesions were diagnosed by ABVS. Among them, BI-RADS grade 38 were classified as grade Ⅱ, including 14 normal proliferative lesions, 15 breast fibroids, 3 breast intraductal papillomas, 5 with hyperplasia and 1 with carcinoma in situ. There were 53 BI-RADS grade Ⅲ, including 4 common proliferative lesions, 28 breast fibroids, 9 breast intraductal papillomas, 8 severe atypical hyperplasia, 2 cancer, 2 invasive ductal carcinoma. Another group of 14 patients with ABVS structural disorder only structural disorder but a family history of breast cancer, age ≥ 40 years old, have a history of breast pain over 6 months, 14 lesions were BI-RADS grade Ⅰ, of which 11 were normal proliferation, severe 2 atypical hyperplasia, 1 in situ carcinoma. Postoperative hematoma incidence was 8.0% (7/87), the cure rate was 97.7% (85/87), the incidence of residual lesions was 2.3% (2/87). Conclusion: ABVS can detect the occult lesions of the breast in time, combined with the minimally invasive vacuum assisted biopsy can diagnose the occult lesions of the breast as early as possible. The combination of the two is especially suitable for the primary hospital without X-ray mammography.