Dong Yunyun, Huang Yuqing, Zhao Xinyu, Qiu Lanyan, Yang Yu, Shi Xian-Quan
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Clinical Epidemiology & EBM Unit, Beijing Friendship Hospital, Capital Medical University; National Clinical Research center for Digestive Diseases, Beijing, China.
Sci Prog. 2025 Apr-Jun;108(2):368504251338660. doi: 10.1177/00368504251338660. Epub 2025 Apr 24.
ObjectiveThe risk factors associated with hematoma formation following ultrasound (US)-guided vacuum-assisted excision (US-VAE) of breast fibroadenoma (FA), particularly those related to the US features of the lesions, remain unclear. This study aimed to investigate the US features influencing hematoma formation after US-VAE of FAs.Materials and methodsThis retrospective analysis included 137 patients with 145 FA nodules who underwent US-VAE at our hospital from January 2018 to August 2024, and subsequently underwent US follow-up to monitor hematoma formation and absorption. The US features of the lesions, including size, number of nodules removed, location, depth, distance from the nipple, peripheral tissue structure, and color Doppler flow features, were retrospectively analyzed to identify the potential risk factors associated with hematoma formation.ResultsHematomas formed in 78 nodules (53.8%) 24-48 h after the US-VAE procedure and disappeared within 6 months in 77 cases (98.7%). In the multivariate logistic regression analysis, FA depth ≥ 1.5 cm or <0.7 cm (OR = 2.490, 95% CI: 1.056-5.872; < 0.05), surrounding tissue mainly composed of fat (OR = 2.471, 95% CI: 1.043-5.857; < 0.05), and rich blood supply (OR = 3.164, 95% CI: 1.444-6.934; < 0.01) were independent risk factors for hematoma formation.ConclusionMost hematomas that formed after US-VAE for breast FA disappeared within 6 months. FA depth ≥ 1.5 cm or <0.7 cm, surrounding tissue mainly composed of fat, and rich blood supply indicated the possibility of hematoma formation after US-VAE.
目的
超声（US）引导下真空辅助切除（US-VAE）乳腺纤维腺瘤（FA）后血肿形成的相关危险因素，尤其是那些与病变的超声特征相关的因素，仍不明确。本研究旨在探讨影响FA患者US-VAE术后血肿形成的超声特征。
材料和方法
本回顾性分析纳入了2018年1月至2024年8月在我院接受US-VAE的137例患者的145个FA结节，随后进行超声随访以监测血肿形成和吸收情况。回顾性分析病变的超声特征，包括大小、切除结节数量、位置、深度、距乳头距离、周围组织结构和彩色多普勒血流特征，以确定与血肿形成相关的潜在危险因素。
结果
78个结节（53.8%）在US-VAE术后24 - 48小时形成血肿，77例（98.7%）在6个月内消失。多因素logistic回归分析显示，FA深度≥1.5 cm或<0.7 cm（OR = 2.490，95%CI：1.056 - 5.872；P<0.05）、周围组织主要由脂肪组成（OR = 2.471，95%CI：1.043 - 5.857；P<0.05）和血供丰富（OR = 3.164，95%CI：1.444 - 6.934；P<0.01）是血肿形成的独立危险因素。
结论
乳腺FA的US-VAE术后形成的大多数血肿在6个月内消失。FA深度≥1.5 cm或<0.7 cm、周围组织主要由脂肪组成以及血供丰富提示US-VAE术后有形成血肿的可能。
