Sanders Linda M, Morgan Dina, Polini Nicole, Mehta Avani
Ambulatory Care Breast Center, Livingston, NJ.
J Breast Imaging. 2020 Jun 3;2(3):240-249. doi: 10.1093/jbi/wbaa015.
To assess the feasibility and accuracy of preoperative wire localization performed one day prior to surgery and the relationship between the time interval following wire placement with migration distance within the time-window examined.
Two trials were performed with next-day mammography to assess migration. Trial 1 used a standard hooked wire (50 patients, 61 wires). Trial 2 employed a looped wire (50 patients, 59 wires). A third trial was subsequently performed (16 patients, 18 wires) using the looped wire without repeat mammograms. Complications were recorded. Comparative statistical analyses were performed between patients in Trial 1 and Trial 2.
In Trials 1 and 2, no wires required readjustment on the day of surgery. Mean and maximum migration were less with the looped wire (range: 0-7 mm) compared to the hooked wire (range: 0-18 mm), allowing for the elimination of next-day mammograms in Trial 3. A Mann-Whitney U test showed no significant difference between the migration distances for the first two trials (P = 0.11). A Chi-square test showed no significant difference in the direction of the migration between the two trials (P = 0.15). There was no correlation between the time interval of localization and needle migration in the first two trials (r = -0.16, P = 0.22 and -0.12, P = 0.36). Specimen radiographs demonstrated the lesion/biopsy marker clip in all cases in all three trials. No infections or bleeding occurred. Two patients developed an allergic reaction to adhesive.
Wire localization performed on the day before surgery is feasible, inexpensive, did not compromise accuracy, and successfully unlinked the radiologic and surgical procedures.
评估术前一天进行的术前导丝定位的可行性和准确性,以及在检查的时间窗口内,导丝放置后时间间隔与移位距离之间的关系。
进行了两项次日乳房X线摄影试验以评估移位情况。试验1使用标准钩状导丝(50例患者,61根导丝)。试验2采用环形导丝(50例患者,59根导丝)。随后进行了第三项试验(16例患者,18根导丝),使用环形导丝且未重复进行乳房X线摄影。记录并发症情况。对试验1和试验2的患者进行了比较统计分析。
在试验1和试验2中,手术当天没有导丝需要重新调整。与钩状导丝(范围:0 - 18毫米)相比,环形导丝的平均和最大移位较小(范围:0 - 7毫米),这使得试验3无需进行次日乳房X线摄影。曼-惠特尼U检验显示前两项试验的移位距离无显著差异(P = 0.11)。卡方检验显示两项试验之间的移位方向无显著差异(P = 0.15)。在前两项试验中,定位时间间隔与针移位之间无相关性(r = -0.16,P = 0.22和 -0.12,P = 0.36)。所有三项试验的所有病例的标本X线片均显示了病变/活检标记夹。未发生感染或出血。两名患者对粘合剂产生过敏反应。
术前一天进行导丝定位是可行的、成本低的,不影响准确性,并成功地将放射学和外科手术程序分开。