Fornage B D
Department of Diagnostic Radiology, Box 57, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA.
J Clin Ultrasound. 1999 Sep;27(7):385-98. doi: 10.1002/(sici)1097-0096(199909)27:7<385::aid-jcu5>3.0.co;2-o.
This article describes the techniques of sonographically guided fine-needle aspiration (FNA) and core-needle biopsy (CNB) of nonpalpable breast lesions. Virtually any nonpalpable breast lesion that is clearly demonstrated on sonograms can be sampled with a needle under ultrasound guidance. Advantages of ultrasound-guided FNA include its pinpoint accuracy, the excellent tolerance by patients, and the ability to aspirate or inject fluid or air. Advantages of ultrasound-guided CNB include a near 100% tissue recovery rate even in fibrous masses, the ability to assess the invasiveness of a cancer, and the fact that tissue cores are readily interpreted by any pathologist. In institutions in which an expert cytopathologist is available, FNA is often used as a first-line biopsy technique, with CNB being reserved for situations in which FNA cannot provide a definitive answer to the question asked. In most institutions, however, CNB has become the standard for percutaneous needle biopsy of breast masses, and sonography has replaced stereotaxy as the standard guidance technique for nonpalpable masses.
本文介绍了超声引导下对不可触及乳腺病变进行细针穿刺抽吸（FNA）和粗针活检（CNB）的技术。实际上，几乎任何在超声检查中清晰显示的不可触及乳腺病变都可在超声引导下用针进行取样。超声引导下FNA的优点包括其精确的定位准确性、患者的良好耐受性以及抽吸或注入液体或空气的能力。超声引导下CNB的优点包括即使在纤维性肿块中组织回收率也接近100%、能够评估癌症的侵袭性以及组织芯很容易被任何病理学家解读。在有专业细胞病理学家的机构中，FNA常被用作一线活检技术，CNB则留作FNA无法对所提问题给出明确答案的情况使用。然而，在大多数机构中，CNB已成为乳腺肿块经皮针吸活检的标准方法，超声检查已取代立体定位法成为不可触及肿块的标准引导技术。
