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磁共振引导下使用 12-18G 同轴混合铁磁性-非磁性系统的立体定向乳腺活检:临床经验和长期结果。

MR-guided stereotactic breast biopsy using a mixed ferromagnetic-nonmagnetic coaxial system with 12- to 18-gauge needles: clinical experience and long-term outcome.

机构信息

Radiology Department, Guglielmo da Saliceto Hospital, Cantone del Cristo, 29100, Piacenza, Italy,

出版信息

Radiol Med. 2013 Oct;118(7):1137-48. doi: 10.1007/s11547-013-0954-7. Epub 2013 Jun 25.

DOI:10.1007/s11547-013-0954-7
PMID:23801401
Abstract

PURPOSE

This study investigated the clinical application of a magnetic-resonance (MR)-guided breast biopsy (MRBB) system consisting of a nonmagnetic coaxial needle and a ferromagnetic core biopsy needle.

MATERIALS AND METHODS

MRBB was performed on 70 breast lesions. The biopsy device consisted of a nonmagnetic 14- to 16-gauge coaxial needle and a ferromagnetic 16- to 18-gauge biopsy needle.

RESULTS

Of the 70 lesions, 29 were malignant and 41 nonmalignant. All 29 malignant lesions underwent surgery and were confirmed as malignant at final histology. Of the 41 nonmalignant lesions, 35 underwent follow-up breast MR imaging (mean, 26 ± 19 months), which demonstrated no lesions changes; six lesions underwent surgery because of poor radiological-pathological correlation; of these 6 lesions, 3 were nonmalignant, one was borderline (lobular carcinoma in situ) and two were malignant (well-differentiated tubular carcinoma and infiltrating ductal carcinoma). Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were, respectively, 93.5%, 100%, 100%, 95.1% and 97.1% if the lobular carcinoma in situ was considered a nonmalignant histological result, and 90.6%, 100%, 100%, 92.7% and 95.7% if the lobular carcinoma in situ was considered malignant.

CONCLUSIONS

MRBB with a ferromagnetic-nonmagnetic coaxial system represented an easy way to perform a biopsy procedure and was easily applicable in the routine clinical setting.

摘要

目的

本研究旨在探讨一种由非磁性同轴针和铁磁性核心活检针组成的磁共振(MR)引导下乳腺活检(MRBB)系统的临床应用。

材料与方法

对 70 个乳腺病变进行了 MRBB。活检设备由非磁性 14-16 号同轴针和铁磁性 16-18 号活检针组成。

结果

70 个病灶中,29 个为恶性,41 个为非恶性。29 个恶性病灶均行手术治疗,最终组织学检查均证实为恶性。41 个非恶性病灶中,35 个进行了随访乳腺 MR 成像(平均 26±19 个月),未见病变变化;6 个病灶因影像学-病理学相关性差而行手术治疗;其中 6 个病灶为非恶性,1 个为交界性(小叶原位癌),2 个为恶性(高分化管状癌和浸润性导管癌)。如果将小叶原位癌视为非恶性组织学结果,则敏感性、特异性、阳性预测值、阴性预测值和诊断准确率分别为 93.5%、100%、100%、95.1%和 97.1%;如果将小叶原位癌视为恶性,则敏感性、特异性、阳性预测值、阴性预测值和诊断准确率分别为 90.6%、100%、100%、92.7%和 95.7%。

结论

使用铁磁-非磁同轴系统进行 MRBB 是一种简单的活检方法,易于在常规临床环境中应用。

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Frequency, upgrade rates, and characteristics of high-risk lesions initially identified with breast MRI.乳腺 MRI 初诊时高危病变的检出率、升级率及特征。
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