Three-dimensional targeting: a new three-dimensional ultrasound technique to evaluate needle position during breast biopsy
Three-dimensional targeting: a new three-dimensional ultrasound technique to evaluate needle position during breast biopsy
复制标题
DOI：
10.1046/j.1469-0705.2000.00182.x
复制
发表时间：
2000-09-01
影响因子：
7.1
通讯作者：
Rettenbacher, T
中科院分区：
文献类型：
--
作者：
Weismann, CF;Forstner, R;Rettenbacher, T
目的探讨二维（2D）针引导下三维（3D）超声在乳腺穿刺活检中的作用。方法188例核心针活检和24例细针穿刺活检在典型的“徒手”穿刺引导下进行三维超声相关。所有病例均使用线性3D US体积扫描仪（5-13 MHz, Voluson 530D, madison - kretztechnik, Zipf, Austria）进行检查。在芯针行程或细针定位后，获取三维US数据集并进行多平面分析。在所有三个平面上检查针的位置被称为“3D瞄准”。66例女性，平均年龄51岁（范围27 ~ 80岁），共出现77个乳腺病变（实性病变55个，囊肿22个），平均直径1.5厘米（范围0.3 ~ 5.0）。结果49例55个乳腺实性病变中，16个为恶性，39个为良性。在53例实性乳腺病变中，进行了188例体针活检（平均3.6例活检/病变）。经芯针活检23个病变（16个恶性，7个良性）手术切除。在22例中，最终组织学证实了芯针标本的结果。1例5毫米病灶核针标本显示不典型小叶增生。术后明确组织学为浸润性小叶癌。用细针穿刺22个囊肿和2个良性实性病变，然后进行穿刺活检。本研究芯针结果的总体敏感性为94%（特异性100%，准确性0.98，阳性预测值1，阴性预测值0.97）。在117例良性（21例）和恶性（12例）病灶的核针穿刺中，3D靶向前瞻性显示病灶命中95例，边缘病灶命中12例，病灶外病灶命中9例。在一个病例中，在最初的大芯针路径后，一个5mm的病变被气泡掩盖，因此在第二次活检过程中3D靶向失败。结论三维超声联合三维靶向技术是一种可靠、客观的工具，可以准确地显示活检过程中芯和细针的空间定位。
Objective To evaluate the role of three-dimensional (3D) ultrasound (US) following needle breast biopsy under two-dimensional (2D) needle guidance.Methods A total of 188 core-needle biopsies and 24 fine-needle aspiration biopsies were 3D US correlated after typical 'freehand' US needle guidance. All cases were examined with a linear 3D US volume scanner (5-13 MHz, Voluson 530D, Medison-Kretztechnik, Zipf, Austria). After core-needle stroke or localization of fine needle, a 3D US data volume set was acquired and a multiplanar analysis performed. This needle position check in all three planes is called '3D targeting'. 66 women with a mean age of 51 years (range, 27 similar to 80 years) showed 77 breast lesions (55 solid lesions, 22 cysts) with a mean diameter of 1.5 (range, 0.3 similar to5.0) cm.Results In 49 women with 55 solid breast lesions, 16 lesions were malignant and 39 lesions benign. In 53 solid breast lesions 188 corp-needle biopsies were Performed (mean 3.6 biopsies/lesion). After core-needle biopsy 23 lesions (16 malignant, seven benign) were surgically removed. In 22 cases final histology confirmed results of the core-needle specimen. In one case a core-needle specimen of a 5 mm lesion showed atypical lobular hyperplasia. The definitive histology after surgery was invasive lobular carcinoma. Twenty-two cysts and two benign solid lesions were punctured with a fine needle followed by aspiration biopsy. The overall sensitivity of core-needle results in this study was 94% (specificity 100%, accuracy 0.98, positive predictive value 1, negative Predictive value 0.97). In 117 core-needle strokes of benign (21) and malignant (12) lesions 3D targeting prospectively revealed 95 lesion hits, Twelve marginal lesion hits and nine out-of-lesion hits. In one case after the initial large core-needle path a 5-mm lesion was disguised by air bubbles, therefore 3D targeting failed during the second biopsy procedure.Conclusion 3D US combined with 3D targeting technique is a reliable and objective tool demonstrating exact spatial positioning of core and fine needle during biopsy procedure.