张云俊+尹娜

[摘要] 目的 探究在MRI的引导下对乳腺病灶中使用穿刺活检术应用的可行性。方法 随机选择该院2013年10月—2017年7月102例具有乳腺可疑病灶的患者进行穿刺活检，术后观察记录该术的成功率以及术后并发症的发生情况，统计随访结果。 结果 所有患者均进行真空抽吸活检术之后统计，整个穿刺用时（30.1±8.37）min，每位患者的取样用针5～6针，平均（4.33±1.08）针，其中有98例（98/102，96.08%）患者的病灶取样获得成功并获得了病理学诊断，4例（4/102，3.92%）患者病灶未能获得病理学诊断。所有患者未发生血肿或感染等严重并发症。 结论 应用穿刺活检术可以使乳腺可疑病灶的取样有效完成并具有很高的安全性，从而使得对于乳腺有可疑病灶的患者的临床治疗进行更好的指导。

[关键词] MRI；乳腺病灶；活检术；应用

[中图分类号] R445 [文献标识码] A [文章编号] 1674-0742（2017）10（c）-0181-03

Application of MRI-guided Biopsy of Breast Lesions

ZHANG Yun-jun1， YIN Na2

1.Radiology Department， Jiangsu Province Tumor Hospital， Nanjing， Jiangsu Province， 210009 China； 2.CT Room， Jiangsu Province Tumor Hospital， Nanjing， Jiangsu Province， 210009 China

[Abstract] Objective This paper tries to explore the feasibility of using biopsy in breast lesions under the guidance of MRI. Methods A total of 102 patients with suspected breast lesions treated in this hospital from October 2013 to July 2017 were enrolled in this study. The success rate and the postoperative complications were recorded and the follow-up results were concluded. Results All patients underwent vacuum aspiration biopsy. The total puncture was （30.1±8.37）min， and each patient was sampled with 5 to 6 needles and average needles were （4.33±1.08）needles， 98 cases of samples （98/102， 96.08%） were successfully obtained and pathological diagnosis was obtained. The pathological diagnosis of 4 patients （4/102， 3.92%） was not obtained. All patients did not develop serious complications such as hematoma or infection. Conclusion Vacuum assisted biopsy can effectively diagnose the suspicious lesions of mammary gland with high safety， which provides better guidance for the clinical treatment of patients with suspicious lesions of mammals.

[Key words] MRI； Breast lesions； Biopsy； Application

核磁共振检查磁共振成像（Nuclear Magnetic Resonance Imaging， MRI），是影像学中继CT之后的有一大进步，拥有较高的软组织分辨率[1]，可以检查到更多难以发现的隐匿病灶，对乳腺存在的刻意病灶有着较高的敏感性。其不足之处在于在对多种良性病变和正常腺体的动态增强和形态学特点较难明显与恶性病变区分[2]，因而其特异性着实有待提高。有统计显示在乳腺查体以及平片中未曾发现乳腺癌的高危人群中，利用MRI可以检出2%～7%的乳腺癌[3]。根据美国癌症协会指南中的规定，在利用MRI进行乳腺可疑病灶筛查时，必须同时具备MRI引导下进行穿刺活检的能力，这是由于大多早期乳腺癌只能经由MRI检出[4]。……