数字乳腺断层融合摄影引导麦默通真空辅助系统在乳腺钙化活检中的效果观察

王强 卓睿 龚柳燕

[摘要] 目的 探討在数字乳腺断层融合摄影引导下麦默通真空旋切术在乳腺钙化活检中的临床效果及应用价值。方法 选择2018年1月～2019年10月我院收治入院的45例断层钼靶示乳腺钙化的患者作为研究对象，在乳腺断层钼靶引导定位下，分别采取空心针（CNB）穿刺活检病理诊断（对照组）和麦默通（MMT）真空辅助旋切活检病理诊断（实验组），术后比较两组的临床效果。 结果 实验组和对照组活检病理准确率分别为100.0%、91.1%，钙化活检准确率分别为100.0%、95.5%，两组敏感性分别为100.0%、63.6%，两组并发症总体发生率分别为31.1%、15.6%。两组经统计学检验后，P均<0.05，可以看出实验组钙化活检准确率、病理准确率、敏感性均高于对照组，实验组术后并发症发生率高于对照组。 结论 数字乳腺断层融合摄影引导下麦默通真空辅助旋切活检术诊断乳腺钙化病灶，是一种准确、高效、微创的诊断方法，可作为乳腺可疑钙化活检的首选方法，值得临床广泛开展。

[关键词] 数字乳腺断层融合摄影;麦默通;真空活检;乳腺钙化

[中图分类号] R737.9          [文献标识码] B          [文章编号] 1673-9701（2020）15-0072-04

Observation on the effect of digital tomosynthesis mammography-guided mammotome vacuum-assisted system in breast calcification biopsy

WANG Qiang   ZHUO Rui   GONG Liuyan   QIU Ping

Department of Breast， Guilin Hospital of Chinese Medicine in Guangxi Zhuang Autonomous Region， Guilin   541000， China

[Abstract] Objective To explore the clinical effect and application value of mammotome vacuum-assisted rotary resection under the guidance of digital tomosynthesis mammography in breast calcification biopsy. Methods From January 2018 to October 2019， 45 patients with mammary gland calcification shown by molybdenum-targeted tomosynthesis who were admitted to our hospital were selected as the research subjects. Under the locating guidance of molybdenum-targeted tomosynthesis mammography， the hollow needle（CNB） biopsy pathological diagnosis was performed（control group） and the Mammotome（MMT） vacuum-assisted rotary biopsy pathological diagnosis was performed（experimental group）. The clinical effects of the two groups were compared after the surgery. Results The pathological accuracy of biopsy in the experimental group and control group was 100.0% and 91.1%， respectively. The accuracy of calcification biopsy was 100.0% and 95.5%， respectively. The sensitivity of the two groups was 100.0% and 63.6%， respectively. The overall incidence of complications in the two groups was 31.1% and 15.6%， respectively. After statistical tests in both groups， the P<0.05 at all， which showed that the accuracy of calcification biopsy， pathological accuracy of biopsy， sensitivity， and specificity in the experimental group were higher than those in the control group， and the incidence rate of postoperative complications was higher in the experimental group than in the control group. Conclusion Mammoth vacuum-assisted rotary biopsy guided by digital tomosynthesis mammography is an accurate， efficient and minimally invasive diagnostic method for breast calcification， which can be used as the primary choice for breast biopsy of suspicious calcification， and is thus worth extensive clinical development.

[Key words] Digital tomosynthesis mammography; Mammotome; Vacuum biopsy; Breast calcification

目前乳腺癌在我国的发病率逐年增长，发病年龄有年轻化趋势，已成为威胁人类健康的主要恶性肿瘤[1]。随着每年妇女两癌筛查的深入开展，乳腺X线摄片的广泛应用，临床未触及肿块而X线摄片发现的可疑钙化病灶日益增多，为保证广大女性的身体健康，对乳腺恶性钙化早期发现、早期诊断和早期治疗是提高乳腺癌生存率的关键。乳腺X线检查技术用于乳腺钙化较为敏感，具有无创性和可重复性，能有效鉴别良恶性钙化，但在普通二维乳腺X线片上由于腺体组织的重叠会影响到病变的检出与诊断，而数字乳腺断层融合摄影（Digital breast tomosynthe-sis，DBT）是一项新的数字乳腺摄影方法，它是由一系列从不同角度拍摄所获得的低剂量X线图像经重建后合成的断层图像，能分层更加准确定位病灶的位置[2]。……