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目的探讨X线下透明质酸(HA)定位乳腺钙化灶后B超引导真空辅助活检的可行性。方法对乳腺钙化灶患者(BI-RADS评级为4级及以上)行X线下HA定位乳腺钙化灶后B超引导真空辅助活检,共38例41侧。其中同侧乳房钙化灶合并肿物(彩超BI-RADS 3级及以上)一期活检17例17侧。结果活检成功率97.6%(40/41),HA定位每侧耗时15~25 min,中位时间20 min;真空辅助旋切每侧15~30 min,中位时间24 min(包括肿物切除)。术后病理:导管内癌伴早期浸润2例,导管内癌2例,乳腺导管上皮轻中度不典型增生3例。术后出现皮下瘀斑3例,血肿1例,局部凹陷3例,未见其他严重并发症。结论 X线下HA定位乳腺钙化灶后B超引导真空辅助活检对T0期乳腺癌的早期诊断和SVAB活检一样具有较高的临床应用价值。该方法具有创伤小、成功率高、更适合于小乳房、同侧乳房钙化灶和肿物可一期活检等特点。
Objective To investigate the feasibility of using B-guided vacuum assisted biopsy in the localization of hyaluronic acid (HA) under calcification in X-ray. Methods A total of 38 patients with breast calcification (BI-RADS grade 4 and above) underwent B-guided vacuum assisted biopsy with HA-localized breast calcification under X-ray. Among them, ipsilateral breast calcification with mass (BI-RADS grade 3 and above) 17 cases of 17 cases of biopsy. Results The success rate of biopsy was 97.6% (40/41). HA localization took 15-25 min on each side and the median time was 20 min. The time of vacuum assisted biopsy was 15-30 min on each side and the median time was 24 min ). Postoperative pathology: ductal carcinoma with early invasion in 2 cases, ductal carcinoma in 2 cases, ductal epithelium mild to moderate dysplasia in 3 cases. Postoperative subcutaneous ecchymosis in 3 cases, hematoma in 1 case, partial depression in 3 cases, no other serious complications. Conclusions B-guided vacuum assisted biopsy with HA-localized breast calcification under X-ray has the same high clinical value as early diagnosis and SVAB biopsy of T0 breast cancer. The method has the characteristics of small trauma, high success rate, more suitable for small breasts, ipsilateral breast calcification and tumor biopsy.