乳腺良性结节超声引导经皮微波消融治疗初步研究
刘慧, 张晶, 韩治宇, 梁萍, 于晓玲, 张冰松
100853 北京,中国人民解放军总医院介入超声科
Preliminary study of ultrasound-guided percutaneous microwave ablation therapy for benign breast nodules
LIU Hui, ZHANG Jing, HAN Zhiyu, LIANG Ping, YU Xiaoling, ZHANG Bingsong
Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, China
摘要 目的 初步探讨经皮微波消融治疗乳腺良性结节的安全性与有效性。方法 超声引导下经皮微波消融治疗8例患者的13个乳腺良性病灶,治疗前经皮穿刺组织活检行病理检查,治疗过程中及治疗后观察记录患者不良反应。治疗前后均行超声造影检查,评价病灶消融效果。 结果13个病灶均径为0.7~4.9 cm,治疗微波剂量为30 W,120~1 100 s,治疗后即刻静脉超声造影显示13个病灶均无造影剂灌注,患者均无明显不适,微波电极植入处皮肤表面均无明显改变。治疗中及治疗后无并发症或不良反应发生。治疗后6个月病灶缩小率为69.9%~75.9%。结论 超声引导经皮微波消融治疗能有效灭活乳腺良性结节,创伤微小、安全,治疗省时,较适用于未婚未育年轻女性乳腺多发良性结节保守治疗。
关键词 :
乳腺疾病 ,
超声检查 ,
介入性 ,
微波 ,
导管消融术
Abstract :Objective To evaluate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation therapy for benign breast nodules.Methods Eight women with 13 benign breast benign breast nodules underwent ultrasound-guided percutaneous microwave ablation therapy. Core needle biopsy was performed before treatment. Adverse effects were recorded during and after treatment. Contrast-enhanced ultrasound (CEUS) was performed before and after treatment to evaluate the ablation effectiveness.Results Nodule diameter ranged from 0.7 cm to 4.9 cm. Microwave was used at 30 W for 120 s to 1100 s. No perfusion was found within all neoplasms under contrast-enhanced ultrasound immediately after treatment. All patients had no obvious discomforts. There was no noticeable change on the skin surface where antenna needle was inserted. No complications or adverse effects were observed during and after the treatment. The shrinkage rate of the nodule volume at 6-month follow-up ranged from 69.9% to 75.9%.Conclusion Ultrasound-guided percutaneous microwave ablation therapy is a convenient, effective, safe and minimally invasive way for benign breast nodules. It is applied specially to the conservative treatment for the unmarried young women with multiple benign breast nodules.
Key words :
Breast Diseases
Ultrasonography, Interventional
Microwaves
Catheter Ablation
收稿日期: 2015-02-11
基金资助: 国家自然科学基金(81371562)
通讯作者:
张晶(zjbch@sina.com)
引用本文:
刘慧, 张晶, 韩治宇, 梁萍, 于晓玲, 张冰松. 乳腺良性结节超声引导经皮微波消融治疗初步研究[J]. 中国生育健康杂志, 2016, 27(2): 119-122.
LIU Hui, ZHANG Jing, HAN Zhiyu, LIANG Ping, YU Xiaoling, ZHANG Bingsong. Preliminary study of ultrasound-guided percutaneous microwave ablation therapy for benign breast nodules. Chinese Journal of Reproductive Health, 2016, 27(2): 119-122.
链接本文:
http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2016/V27/I2/119
1 Hahn M,Pavlista D,Danes J,et al.Ultrasound guided cryoablation of fibroadenomas.Ultraschall Med,2013,34:64-68. 2 Wilkinson S,Forrest AP.Fibro-adenoma of the breast.Br J Surg,1985,72:838-840. 3 Amin AL,Purdy AC,Mattingly JD,et al.Benign breast disease.Surg Clin North Am,2013,93:299-308. 4 Sacks D,McClenny TE,Cardella JF,et al.Society of interventional radiology clinical practice guidelines.J Vasc Interv Radiol,2003,14:S199-S202. 5 Liu H,Huang CK,Yu PC,et al.Retromammary approach for endoscopic resection of benign breast lesions.World J Surg,2009,33:2572-2578. 6 Kitamura K,Hashizume M,Kataoka A,et al.Transaxillary approach for the endoscopic extirpation of benign breast tumors.Surg Laparosc Endosc,1998,8:277-279. 7 Grady I,Gorsuch H,Wilburn-Bailey S.Long-term outcome of benign fibroadenomas treated by ultrasound-guided percutaneous Excision.Breast J,2008,14:275-278. 8 Luo HJ,Chen X,Tu G,et al.Therapeutic application of ultrasound-guided 8-gauge mammotome system in presumed benign breast Lesions.Breast J,2011,17:490-497. 9 Wang ZL,Li JL,Su L,et al.An evaluation of a 10-gauge vacuum-assisted system for ultrasound-guided excision of clinically benign breast lesions.Breast,2009,18:192-196. 10 Hynynen K,Pomeroy O,Smith DN,et al.MR imaging-guided focused ultrasound surgery of fibroadenomas in the breast:a feasibility study.Radiology,2001,219:176-185. 11 Marqa MF,Mordon S,Betrouni N.Laser interstitial thermotherapy of small breast fibroadenomas:numerical simulations.Lasers Surg Med,2012,44:832-839. 12 Liu FY,Yu XL,Liang P,et al.Comparison of percutaneous 915 MHz microwave ablation and 2450 MHz microwave ablation in large hepatocellular carcinoma.Int J Hyperthermia,2010,26:448-455. 13 Wolf FJ,Grand DJ,Machan JT,et al.Microwave ablation of lung malignancies:Effectiveness,CT findings,and safety in 50 patients.Radiology,2008,247:871-879. 14 Liang P,Wang Y,Zhang D,et al.Ultrasound guided percutaneous microwave ablation for small renal cancer:Initial experience.J Urol,2008,180:844-848. 15 Wang Y,Liang P,Yu X,et al.Ultrasound-guided percutaneous microwave ablation of adrenal metastasis:Preliminary results.Int J Hyperthermia,2009,25:455-461. 16 Zhang J,Feng L,Zhang BS,et al.Ultrasound-guided percutaneous microwave ablation for symptomatic uterine fibroid treatment - A clinical study.Int J Hyperthermia,2011,27:510-516. 17 Zhou WB,Zha XM,Liu XA,et al.US-guided percutaneous microwave coagulation of small breast cancers:a clinical study.Radiology,2012,263:364-373. (
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