Taylor Donna
Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia School of Surgery, University of Western Australia, Crawley, Western Australia.
BMJ Case Rep. 2015 Jan 23;2015:bcr2014206827. doi: 10.1136/bcr-2014-206827.
Two women underwent stereotactic sampling of mammographically detected lesions with insertion of breast biopsy markers. Localisation of the malignant lesions was performed using iodine 125 seeds, with bracketing of the edges of the larger lesion. The seeds/lesions were located and excised using a γ probe. Liga clips attached to peripheral sutures at the edges of the specimen enabled radiographic orientation. Surgeon and radiologist found the specimen radiographs difficult to interpret. In one case the surgeon thought the lesion had been removed, mistaking the iodine seed for the biopsy marker. The radiologist noted absence of the biopsy marker and marginal calcifications but was concerned the seed was absent. Widening the window level allowed seed identification, revealing a characteristic rectangular radiolucent area in what had been interpreted as a Liga clip. Correct interpretation of the findings helped guide lesion removal, intraoperative margin re-excision and confirmed (125)I seed retrieval.
两名女性接受了乳腺钼靶检测病变的立体定向采样，并插入了乳腺活检标记物。使用碘125种子对恶性病变进行定位，将较大病变的边缘进行标记。使用γ探头定位并切除种子/病变。标本边缘外周缝合线上附着的结扎夹可实现放射学定位。外科医生和放射科医生发现标本X线片难以解读。在一个病例中，外科医生认为病变已被切除，将碘种子误认为活检标记物。放射科医生注意到活检标记物缺失且边缘有钙化，但担心种子也缺失。加宽窗宽后可识别种子，在原本被解读为结扎夹的部位发现一个特征性的矩形透光区。对检查结果的正确解读有助于指导病变切除、术中切缘再次切除并确认（125）I种子取出。
