Heywang-Köbrunner S H, Smolny T, Schaumlöffel U, Heinig A, Buchmann J, Lampe D
Institut für Radiologie, Martin-Luther-Universität Halle/Saale.
Zentralbl Chir. 1998;123 Suppl 5:66-9.
Results of 3 minimal invasive techniques for breast biopsy of clinically occult lesion are presented. 1. Mammographically guided Site-Select biopsies allow removal of tissue in one piece using a large diameter core biopsy instrument (similar to the ABBI-principle). However the overlying subcutaneous tissue is saved. No technical problems occurred in 13/13 diagnostic biopsies. Complete removal was, however, only possible in 2/4 tumors < 1 cm due to tissue shift during insertion of the instrument. 2. Mammographically guided vacuum biopsy also allows contiguous removal of areas of 1.2-1.8 cm diameter, while blood is suctioned out, as well. 3 stereotaxic miscalculations were immediately recognized. Diagnostic accuracy in 405 biopsies so far is 100%. The examination was very well tolerated by the patients. 3. By means of a specially developed biopsy coil and vacuum biopsy percutaneous in- or excisional biopsy of enhancing lesions visible by MRI alone has been realized by us for the first time. 24/25 diagnoses are definitely representative--as proven by lack of enhancement after biopsy. One diagnosis, which was uncertain due to overlying blood, is being followed. Minimal invasive methods may open up new perspectives.
本文介绍了三种用于乳腺临床隐匿性病变活检的微创技术的结果。1. 乳腺X线引导下的位点选择活检，使用大口径活检针可整块切除组织（类似于ABBI原理）。不过，皮下组织得以保留。13例诊断性活检均未出现技术问题。然而，在4例直径<1cm的肿瘤中，由于器械插入时组织移位，仅2例实现了完整切除。2. 乳腺X线引导下的真空活检，在吸出血液的同时，还能连续切除直径1.2 - 1.8cm的区域。立即识别出3例立体定向计算错误。迄今为止，405例活检的诊断准确率为100%。患者对该检查耐受性良好。3. 通过特制的活检线圈和真空活检，我们首次实现了仅通过MRI可见的强化病变的经皮穿刺活检或切除活检。24/25例诊断具有明确代表性——活检后无强化可证。1例因有血液覆盖而诊断不确定的病例正在随访中。微创方法可能会开辟新的前景。
