Hertl K, Marolt-Music M, Kocijancic I, Prevodnik-Kloboves V, Zgajnar J
Department of Radiology, Institute of Oncology, Ljubljana.
Ultraschall Med. 2009 Feb;30(1):33-6. doi: 10.1055/s-2007-963724. Epub 2008 Sep 4.
Clinically apparent haematomas are among most frequent complications after vacuum-assisted breast biopsy (VABB). We evaluated the prevalence and persistence of sonographically (US) detected haematomas and other tissue changes at the biopsy site after VABB.
We examined 48 women who underwent stereotactic 11G needle VABB; the majority of them had mammographically detected microcalcifications. US examination of the breast biopsy site was performed one week after the VABB in 48 patients, and in 45 patients once again three weeks after the VABB. In 13/45 patients US-guided fine needle aspiration biopsy (FNAB) of the changes visualised was performed 3 weeks after the biopsy.
One week after the VABB, a haematoma at the biopsy site was detected in 45/48 (94 %) patients (mean length 16.3 mm, mean width 3.6 mm). Three weeks after the VABB, haematoma was detected in 25/45 patients (55 %) (mean length 9.3 mm, mean width 2.7 mm), and architectural distortion in 13/45 patients (29 %), in 7/45 patients (16 %), no changes were found. In 13 patients in whom FNAB (fine needle aspiration biopsy) was performed, haematoma was found in 6/13, fat necrosis in 3/13, reactive changes in 2/13, whereas 2/13 samples were unsatisfactory.
The changes at the biopsy site can be seen by US in most of the patients one and three weeks after the VABB. These changes could potentially be used for US guidance and localisation of microcalcifications in patients requiring surgical biopsy.
临床上明显的血肿是真空辅助乳腺活检（VABB）后最常见的并发症之一。我们评估了VABB后超声（US）检测到的活检部位血肿及其他组织变化的发生率和持续时间。
我们检查了48例行立体定向11G针VABB的女性；她们大多数在乳腺钼靶检查中发现了微钙化。48例患者在VABB后1周进行了乳腺活检部位的超声检查，45例患者在VABB后3周再次进行了检查。在13/45例患者中，活检后3周对超声显示的变化进行了超声引导下细针穿刺活检（FNAB）。
VABB后1周，4/4（94%）例患者活检部位检测到血肿（平均长度16.3mm，平均宽度3.6mm）。VABB后3周，25/45例患者检测到血肿（55%）（平均长度9.3mm，平均宽度2.7mm），13/45例患者出现结构扭曲（29%），7/45例患者（16%）未发现变化。在13例进行FNAB的患者中，6/13发现血肿，3/13发现脂肪坏死，2/13发现反应性改变，而2/13的样本不满意。
VABB后1周和3周，大多数患者的活检部位变化可通过超声观察到。这些变化可能用于超声引导和定位需要手术活检患者的微钙化灶。
