CAJ | 학술논문

目的：比较16G及18G空芯针对不同声像学特征的乳腺病灶行超声引导穿刺活检的准确性。方法行超声引导16G及18G空芯针乳腺穿刺活检后外科手术切除的病例955例。超声引导穿刺活检病理结果与手术切除病理结果对比，根据超声声像学特征分组分析穿刺活检的符合率、敏感性、假阴性率、低估率。结果穿刺活检病理结果中，恶性占84.1%，高危占8.4%，良性占7.5%。16G及18G穿刺活检与术后病理的总符合率分别为92.4%及92.8%；完全敏感性及假阴性率均分别为98.6%及1.4%；高危低估率及导管内癌低估率分别为16G：48.0%及46.2%；18G：53.3%及41.2%。两种方法间无统计学差异（P>0.01）。同时，对于两种方法，肿块型病灶的穿刺符合率均明显高于非肿块型病灶（P<0.01）。对于直径小于等于10 mm的肿块型病灶，穿刺符合率明显降低（P<0.01）。含钙化病灶与不含钙化病灶间的穿刺符合率无统计学差异（P>0.01）。结论超声引导16G及18G空芯针穿刺活检对于诊断直径大于10 mm的肿块型乳腺病灶均是准确的方法。
목적：비교16G급18G공심침대불동성상학특정적유선병조행초성인도천자활검적준학성。방법행초성인도16G급18G공심침유선천자활검후외과수술절제적병례955례。초성인도천자활검병리결과여수술절제병리결과대비，근거초성성상학특정분조분석천자활검적부합솔、민감성、가음성솔、저고솔。결과천자활검병리결과중，악성점84.1%，고위점8.4%，량성점7.5%。16G급18G천자활검여술후병리적총부합솔분별위92.4%급92.8%；완전민감성급가음성솔균분별위98.6%급1.4%；고위저고솔급도관내암저고솔분별위16G：48.0%급46.2%；18G：53.3%급41.2%。량충방법간무통계학차이（P>0.01）。동시，대우량충방법，종괴형병조적천자부합솔균명현고우비종괴형병조（P<0.01）。대우직경소우등우10 mm적종괴형병조，천자부합솔명현강저（P<0.01）。함개화병조여불함개화병조간적천자부합솔무통계학차이（P>0.01）。결론초성인도16G급18G공심침천자활검대우진단직경대우10 mm적종괴형유선병조균시준학적방법。
Objective To assess the accuracy of ultrasound-guided 16G and 18G core needle biopsy for detecting ultrasound visible breast lesions with different sonographic features. Methods A total of 955 sonographically detected breast lesions examined with ultrasound-guided core needle biopsy (US-CNB) and subsequently surgically excised from July 2005 to July 2012 were retrospectively reviewed. Histological findings of US- CNB and the surgical specimens were analyzed for agreements, sensitivities, false negative rates, and underestimate rates according to different sonographic features. Results The pathological results of the US-CNB showed malignant lesions in 84.1%, high-risk lesions in 8.4%, and benign lesions in 7.5%of the samples. The overall agreement rates were 92.4% for 16G CNB and 92.8% for 18G CNB; their complete sensitivities and false negative rates were both 98.6%and 1.4%, respectively;the high-risk underestimate rates and DCIS underestimate rates were 48.0% and 46.2% for 16G CNB vs 53.3% and 41.2% for 18G CNB, showing no significant difference between the two groups (P>0.01). For both 16G and 18G CNB, the agreements were better for mass lesions than for non-mass lesions (P<0.01). For the mass lesions with a diameter no greater than 10 mm, the agreement rates were lower than the overall data (P<0.01). Calcification in the lesions did not affect the agreement rates (P>0.01). Conclusion Ultrasound-guided 16G and 18G CNB are both accurate methods for evaluating ultrasound visible breast mass lesions with a diameter larger than 10 mm.