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目的:探讨乳腺数字摄影(乳腺DR)引导下对乳腺微小病灶病理活检定位穿刺新技术与留置导丝引导手术切除活检的临床应用价值。方法:对临床触诊阴性,而乳腺DR显示的微小病灶,测算出病灶距离皮肤最近点位并确定穿刺的最佳角度和深度,改变传统穿刺方法,真正实现360°的全方位定位穿刺技术。用该定位穿刺技术留置导丝于可疑病灶区,指引手术切取组织行病理学检查。结果:48例微小病灶计算后倾斜角度为-150°～160°,穿刺深度为2.6～4.6cm。以误差≤5mm为满意,穿刺满意率97.6%;病理结果乳腺癌占所有穿刺病例37.5%。结论:该定位穿刺技术改变了以往只能从上方及侧方两个方向的传统穿刺方法,是经测量确定病灶与皮肤最近点360°的全方位穿刺技术。经临床使用以来,具有操作简单、定位准确、穿刺与手术切检组织损伤最小等诸多优点,对早期发现乳腺癌,进而提高患者生存率具有重要的临床意义。
Objective: To investigate the clinical value of biopsy with biopsy guided by digital biopsy (breast DR) guided by breast biopsy and pathological biopsy of minimally invasive breast lesions. Methods: For clinical lesions of the palpation negative, and breast DR showed tiny lesions, calculate the nearest spot from the skin lesions and determine the best angle and depth of the puncture, change the traditional puncture method to truly 360 ° positioning puncture technology. The positioning puncture technique indwelling guide wire in the suspicious lesion area, guiding surgical removal of tissue pathology. Results: The calculated tilt angle of the 48 cases was -150 ° ~ 160 ° and the puncture depth was 2.6 ~ 4.6 cm. Satisfaction rate was ≤5mm, satisfactory rate of puncture was 97.6%. Pathological findings Breast cancer accounted for 37.5% of all puncture cases. CONCLUSION: This technique of positioning and puncturing has changed the traditional puncture method that can only be used from above and from the lateral direction in the past. It is an omni-directional puncturing technique that has been measured to determine the nearest point of lesion and skin by 360 °. After clinical use, it has the advantages of simple operation, accurate positioning, minimum tissue damage caused by puncture and surgical incision, which has important clinical significance for early detection of breast cancer and further improvement of patient survival rate.