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超声引导下乳腺病变的术前定位:一个不错的选择。

Ultrasound-guided preoperative localization of breast lesions: a good choice.

作者信息

Carlino Giorgio, Rinaldi Pierluigi, Giuliani Michela, Rella Rossella, Bufi Enida, Padovano Federico, Ciardi Chiara, Romani Maurizio, Belli Paolo, Manfredi Riccardo

机构信息

Department of Radiology, Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.

出版信息

J Ultrasound. 2019 Mar;22(1):85-94. doi: 10.1007/s40477-018-0335-0. Epub 2018 Oct 26.

Abstract

PURPOSE

The aim of the study was to verify whether ultrasound (US)-guided preoperative localization of breast lesions is an adequate technique for correct and safe surgical resection and to contribute positively and effectively to this topic in the literature with our results.

METHODS

From June 2016 to November 2016, 155 patients with both benign and malignant breast lesions were selected from our institute to undergo US localization before surgery. The lesions included were: sonographically visible and nonpalpable lesions; palpable lesions for which a surgeon had requested US localization to better evaluate the site and extension; sonographically visible, multifocal breast lesions, both palpable and nonpalpable. US localization was performed using standard linear transducers (Siemens 18 L6, 5.5-8 MHz, 5.6 cm, ACUSON S2000 System, Siemens Medical Solutions). The radiologist used a skin pen to mark the site of the lesion, and the reported lesion's depth and distance from the nipple and pectoral muscle were recorded. The lesions were completely excised by a team of breast surgeons, and the surgical specimens were sent to the Radiology Department for radiological evaluation and to the Pathology Department for histological assessment.

RESULTS

In 155 patients who underwent to preoperative US localization, 188 lesions were found, and the location of each lesion was marked with a skin pen. A total of 181 lesions were confirmed by the final histopathologic exam (96.28%); 132 of them (72.92%) were malignant, and 124 of these (93.93%) showed free margins.

CONCLUSIONS

US-guided preoperative localization of sonographically visible breast lesions is a simple and nontraumatic procedure with high specificity and is a useful tool for obtaining accurate surgical margins.

摘要

目的

本研究的目的是验证超声(US)引导下乳腺病变的术前定位是否是一种用于正确、安全手术切除的充分技术,并通过我们的结果为该领域的文献做出积极有效的贡献。

方法

2016年6月至2016年11月,从我院选取155例患有良性和恶性乳腺病变的患者在手术前行超声定位。纳入的病变包括:超声可见但触诊不可及的病变;外科医生要求进行超声定位以更好地评估部位和范围的可触及病变;超声可见的多灶性乳腺病变,包括可触及和触诊不可及的。使用标准线性换能器(西门子18 L6,5.5 - 8 MHz,5.6 cm,ACUSON S2000系统,西门子医疗解决方案)进行超声定位。放射科医生用皮肤标记笔标记病变部位,并记录所报告病变的深度以及距乳头和胸肌的距离。病变由一组乳腺外科医生完整切除,手术标本送至放射科进行放射学评估,并送至病理科进行组织学评估。

结果

在155例接受术前超声定位的患者中,共发现188个病变,每个病变的位置均用皮肤标记笔标记。最终组织病理学检查证实了181个病变(96.28%);其中132个(72.92%)为恶性,其中124个(93.93%)切缘阴性。

结论

超声引导下对超声可见乳腺病变进行术前定位是一种简单、无创且特异性高的方法,是获得准确手术切缘的有用工具。

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