Pesce Karina, Chico Maria Jose, Binder Fernando
Breast Imaging and Interventional Radiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Health Informatics Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Radiol Case Rep. 2020 Oct 29;16(1):35-39. doi: 10.1016/j.radcr.2020.10.025. eCollection 2021 Jan.
Breast pseudoaneurysm is an extremely rare complication of interventional breast procedures. Pregnancy and lactation are associated with increased breast vascularization, which may act as a risk factor. We present the case of a 36-year-old woman in the third trimester of a spontaneous twin pregnancy, who presented with a newly-detected BI-RADS 4 mass in her right breast. The patient requested not to defer a biopsy until after the pregnancy, and an ultrasound-guided breast core biopsy was performed. The patient presented bleeding during the procedure, but no hematomas or other vascular lesions were immediately detected. During follow-up, a breast ultrasound revealed an anechoic circumscribed mass and high-velocity blood flow. The color Doppler showed a spiral blood flow with the Yin-Yang sign, together with a communication channel between the sac and feeding artery. A diagnosis of breast pseudoaneurysm was made. The patient was managed conservatively, and breastfeeding continued normally. This case report highlights the importance of color Doppler in the detection of pseudoaneurysms, and the need to consider deferring invasive breast procedures in pregnant women when possible.
乳腺假性动脉瘤是介入性乳腺手术极为罕见的并发症。妊娠和哺乳期与乳腺血管增生增加有关,这可能是一个危险因素。我们报告一例36岁处于自然双胎妊娠晚期的女性病例,其右乳新发现一个BI-RADS 4类肿块。患者要求不在妊娠后再推迟活检,遂进行了超声引导下乳腺粗针穿刺活检。术中患者出现出血,但未立即发现血肿或其他血管病变。随访期间,乳腺超声显示一个无回声边界清晰的肿块及高速血流。彩色多普勒显示呈“阴阳”征的螺旋血流,以及瘤腔与供血动脉之间的交通通道。诊断为乳腺假性动脉瘤。患者接受保守治疗,母乳喂养正常进行。本病例报告强调了彩色多普勒在假性动脉瘤检测中的重要性,以及在可能的情况下考虑推迟对孕妇进行侵入性乳腺手术的必要性。