Hassard Mary K, McCurdy Lauren I, Williams Jackie C A, Downey Donal B
Department of Diagnostic Radiology and Nuclear Medicine, London Health Sciences Centre, University Hospital, 339 Windemere Rd., PO Box 5339, London, ON N6A 5A5.
Can Assoc Radiol J. 2003 Jun;54(3):155-9.
To evaluate the effectiveness of a training module in teaching residents the skills necessary to perform accurate and safe ultrasound-guided breast biopsies (USGBB).
Twelve residents with no USGBB experience, but variable ultrasound (US) experience, were randomly assigned to 2 groups; 1 group participated in a training module, and the other received no training. Each resident then attempted 30 core biopsies of "lesions" implanted in breast phantoms. Successful biopsies extracted some "lesion" material. "Chest wall" hits were also counted.
The trained residents had significantly fewer "chest wall" hits than the untrained group (p < 0.002), but there was no significant difference in the number of successful biopsies (73% v. 43%, p = 0.09). The subgroup of residents who were USGBB trained but inexperienced in US (n = 4) achieved more successful biopsies (p < 0.05) and fewer "chest wall" hits (p < 0.01) than their matched untrained cohort (n = 3). The trained US-experienced subgroup (n = 2) had fewer "chest wall" hits than the matched untrained subgroup (n = 3; p < 0.05) but similar biopsy success rates. Untrained US-experienced residents (n = 3) had more successful biopsies than untrained US-inexperienced residents (n = 3; p < 0.001) and similar "chest wall" hits.
Residents with training perform USGBBs more safely, and training significantly improves accuracy of USGBB in residents with no US experience. US experience improves biopsy success rates but does not affect safety levels of residents with no USGBB training.
评估一个培训模块在教导住院医师进行准确且安全的超声引导下乳腺活检（USGBB）所需技能方面的有效性。
12名没有USGBB经验但超声（US）经验各异的住院医师被随机分为两组；一组参加培训模块，另一组不接受培训。然后，每位住院医师尝试对植入乳腺模型中的“病变”进行30次核心活检。成功的活检提取到了一些“病变”组织。“胸壁”穿刺也进行了计数。
接受培训的住院医师“胸壁”穿刺次数显著少于未接受培训的组（p < 0.002），但成功活检的数量没有显著差异（73%对43%，p = 0.09）。接受USGBB培训但没有US经验的住院医师亚组（n = 4）比匹配的未接受培训队列（n = 3）获得了更多成功的活检（p < 0.05）且“胸壁”穿刺次数更少（p < 0.01）。有US经验的接受培训亚组（n = 2）的“胸壁”穿刺次数少于匹配的未接受培训亚组（n = 3；p < 0.05），但活检成功率相似。有US经验的未接受培训住院医师（n = 3）比没有US经验的未接受培训住院医师（n = 3；p < 0.001）获得了更多成功的活检，且“胸壁”穿刺次数相似。
接受培训的住院医师进行USGBB操作更安全，并且培训显著提高了没有US经验的住院医师进行USGBB的准确性。US经验可提高活检成功率，但不影响没有USGBB培训的住院医师的安全水平。
