Position of Clip Placement After Vacuum‐Assisted Breast Biopsy: Is a Unilateral Two‐View Postbiopsy Mammogram Necessary?
Position of Clip Placement After Vacuum‐Assisted Breast Biopsy: Is a Unilateral Two‐View Postbiopsy Mammogram Necessary?
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真空辅助乳腺活检后夹子的放置位置：活检后单侧双视图乳房 X 光检查是否必要？
DOI：
10.1046/j.1524-4741.2003.09404.x
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Jennifer Shook
中科院分区：
文献类型：
--
作者：
C. Lehman;Jennifer Shook
摘要：本研究的目的是比较立体定向引导真空辅助乳腺活检（VABB）后当前确定金属夹位置方法的准确性（立即立体定向图像与术后双视图乳房X线照片）。对立体定向VABB期间放置定位夹的101处病变进行了回顾性审查。通过1）立体定位图像（x、y和z坐标）和2）活检后双视图乳腺X线片与活检前双视图乳腺X线片的比较，测量成形夹至病变距离。立体定向图像的平均金属夹-病变距离为5.7 mm，而相同视图和正交视图乳腺X线摄影测量的平均金属夹-病变距离分别为3.6 mm和9.4 mm。立体定向坐标测量与正交视图乳腺X线摄影夹-病变测量相比显示出显著差异（p < 0.001），相同视图乳腺X线摄影与立体定向图像和正交视图乳腺X线摄影相比也显示出显著差异（p < 0.001）。与立体定向图像（n = 0）和相同视图乳腺X线摄影（n = 5）相比，正交视图乳腺X线摄影（n = 19）测量发现的距离病变小于20 mm（定义为具有临床意义）的金属夹数量显著更高（p < 0.001）。基于立体定向图像确定金属夹位置显著低估了金属夹至病变的距离。在VABB期间，在金属夹放置结束时获得的立体定向图像在确定金属夹相对于靶病变的位置方面不可靠。尽管立体定位图像可以确认成形夹的展开，但活检后双视图乳房X线片仍有必要确定成形夹相对于靶病变的位置。
Abstract: The objective of this study was to compare the accuracy of current methods of determining clip location (immediate stereotactic images versus postprocedure two‐view mammograms) after stereotactic‐guided, vacuum‐assisted breast biopsy (VABB). Retrospective review was made of 101 lesions for which a localizing clip was placed during stereotactic VABB. Clip‐to‐lesion distances were measured by 1) stereotactic images (x, y, and z coordinates), and 2) postbiopsy two‐view mammograms compared to prebiopsy two‐view mammograms. The mean clip‐to‐lesion distance was 5.7 mm from stereotactic images, while the mean clip‐to‐lesion distances were 3.6 and 9.4 mm from same‐view and orthogonal‐view mammogram measurements, respectively. Stereotactic coordinate measurements compared to orthogonal‐view mammogram clip‐to‐lesion measurements showed a significant difference (p < 0.001), as did the same‐view mammogram compared to both stereotactic images and orthogonal‐view mammogram (p < 0.001). The number of clips found to be less than 20 mm from the lesion (defined as clinically significant) was significantly higher for measurements from orthogonal‐view mammograms (n = 19) compared to both stereotactic images (n = 0) and same‐view mammograms (n = 5) (p < 0.001). Determination of clip location based on stereotactic images significantly underestimated the clip‐to‐lesion distance. Stereotactic images obtained at the conclusion of clip placement during VABB are not reliable in determining clip location relative to the targeted lesion. Although stereotactic images can confirm deployment of the clip, a two‐view postbiopsy mammogram is necessary to determine clip location relative to the targeted lesion.