Delle Chiaie L, Terinde R
Centre for Ultrasound and Prenatal Diagnosis, Department of Obstetrics and Gynecology, University of Ulm, Ulm, Germany.
Ultrasound Obstet Gynecol. 2004 Apr;23(4):393-7. doi: 10.1002/uog.1001.
The use of three-dimensional (3D) ultrasound may help to determine the exact position of the needle during breast biopsy, thereby reducing the number of core samples that are needed to achieve a reliable histological diagnosis. The aim of this study was to demonstrate the efficacy of 3D ultrasound-validated large-core needle biopsy (LCNB) of the breast.
A total of 360 core needle biopsies was obtained from 169 breast lesions in 146 patients. Additional open breast biopsy was performed in 111 women (127/169 breast lesions); the remaining 42 lesions were followed up for at least 24 months. 3D ultrasound visualization of the needle in the postfiring position was used to classify the biopsy as central, marginal or outside the lesion. Based on this classification it was decided whether another sample had to be obtained.
A median of two core samples per lesion provided for all the lesions a sensitivity for malignancy of 96.9%, specificity of 100%, false-positive rate of 0% and false-negative rate of 3.1%, and for the excised lesions a sensitivity of 96.5%, specificity of 100%, false-positive rate of 0%, false-negative rate of 3.5% and an underestimation rate of 3.4%.
3D ultrasound validation of the postfiring needle position is an efficient adjunct to ultrasound-guided LCNB. The advantages of 3D ultrasound validation are likely to include a reduction in the number of core samples needed to achieve a reliable histological diagnosis (and a possible reduction in the risk of tumor cell displacement), reduced procedure time and lower costs.
使用三维（3D）超声可能有助于确定乳腺活检时针的精确位置，从而减少获得可靠组织学诊断所需的粗针样本数量。本研究的目的是证明3D超声验证的乳腺粗针活检（LCNB）的有效性。
从146例患者的169个乳腺病变中获取了总共360次粗针活检。111名女性（127/169个乳腺病变）进行了额外的开放性乳腺活检；其余42个病变随访至少24个月。使用针在发射后位置的3D超声可视化将活检分类为病变中央、边缘或病变外。基于此分类决定是否需要获取另一个样本。
每个病变平均两个粗针样本对所有病变的恶性肿瘤敏感性为96.9%，特异性为100%，假阳性率为0%，假阴性率为3.1%；对于切除的病变，敏感性为96.5%，特异性为100%，假阳性率为0%，假阴性率为3.5%，低估率为3.4%。
发射后针位置的3D超声验证是超声引导LCNB的有效辅助手段。3D超声验证的优点可能包括减少获得可靠组织学诊断所需的粗针样本数量（以及可能降低肿瘤细胞移位的风险）、减少操作时间和降低成本。
