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乳腺癌手术中氧化再生纤维素的乳腺X线和超声检查结果:5年经验

Mammographic and Ultrasonographic Findings of Oxidized Regenerated Cellulose in Breast Cancer Surgery: A 5-Year Experience.

作者信息

Giuliani Michela, Fubelli Rita, Patrolecco Federica, Rella Rossella, Borelli Cristina, Buccheri Chiara, Di Giovanni Silvia Eleonora, Belli Paolo, Romani Maurizio, Rinaldi Pierluigi, Bufi Enida, Franceschini Gianluca, Bonomo Lorenzo

机构信息

Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.

Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy.

出版信息

Clin Breast Cancer. 2015 Oct;15(5):e249-56. doi: 10.1016/j.clbc.2015.03.008. Epub 2015 Mar 24.

Abstract

BACKGROUND

The purpose of this study was to describe the ultrasonographic (US) and mammographic (MX) findings in patients who underwent breast-conserving surgery followed by oxidized regenerated cellulose (ORC) implantation in the surgical cavity and their size variations in follow-up.

MATERIALS AND METHODS

We retrospectively reviewed 417 MX and 743 US images performed between January 2009 and January 2014 for 262 women who underwent breast-conserving surgery. All patients underwent US, only 203 women underwent MX examination.

RESULTS

In 170 of 262 patients, US examinations showed abnormal findings. Three main US patterns were identified: (1) complex masses: well-encapsulated ipoisoechoic lesions with circumscribed margins with internal hyperechoic nodules (56%); (2) hypoanechoic lesions without internal hyperechoic nodules (24%); and (3) completely anechoic collections (20%). Moreover, Doppler ultrasound examination was performed on all of the patients. In 95 of 203 patients, MX examinations showed abnormalities. Four main MX patterns were identified: (1) round or oval opacity with circumscribed margins (58%); (2) round or oval opacity with indistinct or ill-defined margins (17%); (3) irregular opacity with indistinct or spiculated margins (9%); and (4) architectural distortion or focal asymmetry (15%). Most of the lesions showed a decrease in size at US and MX follow-up examination and the decrease was statistically significant (P < .01).

CONCLUSION

When applied to the surgical residual cavity, ORC aids to control local hemorrhage and reduce the risk of postoperative infections, but can lead to alterations in surgical scar. Thus, knowledge of the radiological findings might allow avoidance of misdiagnosis of tumor recurrence or unnecessary diagnostic examinations.

摘要

背景

本研究旨在描述在接受保乳手术并在手术腔隙植入氧化再生纤维素(ORC)的患者中的超声(US)和乳腺X线摄影(MX)表现及其随访中的大小变化。

材料与方法

我们回顾性分析了2009年1月至2014年1月期间对262例行保乳手术的女性患者进行的417次MX和743次US图像。所有患者均接受了US检查,仅203名女性接受了MX检查。

结果

262例患者中有170例US检查显示异常结果。确定了三种主要的US模式:(1)复杂肿块:边界清晰的等回声病变,内部有高回声结节,边界清晰(56%);(2)无内部高回声结节的低回声病变(24%);(3)完全无回声液性暗区(20%)。此外,对所有患者均进行了多普勒超声检查。203例患者中有95例MX检查显示异常。确定了四种主要的MX模式:(1)边界清晰的圆形或椭圆形不透光区(58%);(2)边界不清或不明确的圆形或椭圆形不透光区(17%);(3)边界不清或有毛刺的不规则不透光区(9%);(4)结构扭曲或局灶性不对称(15%)。大多数病变在US和MX随访检查中显示大小减小,且减小具有统计学意义(P <.01)。

结论

当应用于手术残留腔隙时,ORC有助于控制局部出血并降低术后感染风险,但可导致手术瘢痕改变。因此,了解放射学表现可能有助于避免肿瘤复发的误诊或不必要的诊断检查。

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