Czarnecki D J, Feider H K, Splittgerber G F
Department of Radiology, St. Luke's Medical Center, Milwaukee, WI 53215.
AJR Am J Roentgenol. 1989 Aug;153(2):261-3. doi: 10.2214/ajr.153.2.261.
We compared the efficacy of toluidine blue dye vs methylene blue as a visual marker for breast localizations in vitro and in vivo. In phase 1, the dyes were injected into 10 mastectomy specimens and allowed to diffuse for 24-48 hr. In phase 2, the breasts of four premastectomy patients were injected with the dyes and the dyes were allowed to diffuse for 3 3/4, 12, 24, and 47 hr before mastectomy. In phase 3, the breasts of 18 women in whom 20 breast localizations were performed before excisional biopsy were injected with methylene blue or toluidine blue up to 2 hr 10 min before the biopsy. All excised stained breast tissue was evaluated blindly. The amount of pain associated with injections of the dye was recorded. The 22 women in phases 2 and 3 had had mammograms before, and the parenchymal patterns had been classified according to Wolfe. In the patients injected 3 3/4, 12, 24, and 47 hr before mastectomy, more intense staining with less diffusibility was seen with toluidine blue than with methylene blue. In the 20 localization procedures before excisional biopsy, no difference in intensity of staining or radius of diffusion was seen between methylene blue and toluidine blue with maximal diffusion times of 2 hr 10 min. Breast parenchymal pattern did not correlate with stain intensity or diffusibility. The six patients in whom both methylene blue and toluidine blue were injected and the 18 patients in whom either dye was injected felt less discomfort at the time of injection of toluidine blue than of methylene blue. Our results suggest that toluidine blue causes less discomfort and produces a more intense stain with a smaller diffusion radius than methylene blue regardless of breast parenchymal pattern.
我们比较了甲苯胺蓝染料与亚甲蓝作为乳腺定位视觉标记物在体外和体内的效果。在第1阶段，将染料注入10个乳房切除标本中，使其扩散24 - 48小时。在第2阶段，对4例乳房切除术前患者的乳房注射染料，在乳房切除术前分别让染料扩散3又3/4小时、12小时、24小时和47小时。在第3阶段，对18例在切除活检前进行了20次乳腺定位的女性患者，在活检前长达2小时10分钟时注射亚甲蓝或甲苯胺蓝。对所有切除的染色乳腺组织进行盲法评估。记录与染料注射相关的疼痛程度。第2阶段和第3阶段的22名女性之前都做过乳房X线摄影，实质模式已根据沃尔夫分类法进行分类。在乳房切除术前3又3/4小时、12小时、24小时和47小时注射染料的患者中，与亚甲蓝相比，甲苯胺蓝染色更强烈且扩散性更小。在切除活检前的20次定位操作中，亚甲蓝和甲苯胺蓝在最大扩散时间为2小时10分钟时，染色强度和扩散半径没有差异。乳腺实质模式与染色强度或扩散性无关。同时注射了亚甲蓝和甲苯胺蓝的6例患者以及注射了其中任何一种染料的18例患者，在注射甲苯胺蓝时比注射亚甲蓝时感觉不适更少。我们的结果表明，无论乳腺实质模式如何，甲苯胺蓝引起的不适较少，产生的染色更强烈，扩散半径更小。
