Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

The Results and Usefulness of Marker Clip Placement after Ultrasound-guided Mammotome Excision of Breast Lesion

유방병변의 초음파 유도하 맘모톰 절제 후 표식자 삽입의 결과와 그 유용성

Lee, So-Youn;Kook, Shin-Ho;Kwag, Hyon-Joo
이소연;국신호;곽현주

  • Published : 20050300
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Abstract

Purpose: We wanted to know the results and the usefulness of placing a marker clip (a surgical titanium clip) after ultrasound (US)-guided excisional mammotome biopsy for breast lesion. Materials and Methods: We have placed marker clips at the biopsy sites after performing US-guided excisional mammotome biopsies in 24 cases (mean age; 46 years, mean size of the 12.6 mm, pathologic results; benign in 19 cases, malignant in 5 cases) from Nov. 2003 to Jun. 2004. We designed the needle that we used. Twenty-five cases of follow-up sonography (at 1-month follow-up; 13 cases, at 6-months follow-up; 12 cases) were performed for 18 cases of clip placement. We retrospectively reviewed the success rate and the complications for 24 cases of clip placement, and we analyzed the visibility, conspicuity and location of the clips on 25 cases of follow-up sonography for 18 cases of clip placement. Results: The marker clip is successfully placed in all 24 cases (100%). None of the patients complained of pain or infection, except for 1 case of a large hematoma (3.5 cm). On the follow-up sonography, the titanium clip was well visualized as a short echogenic line on the interval follow-up (for the 1-month follow-up; 85%, for the 6 month follow-up; 84%) and parenchymal composition of the breast was well observed at the location of the clip (intraparenchymal; 80%, parenchyma-fat interface; 90%). The clips were easily found when there was hematoma (85%) or scar (89%). Marker clips were found within the hematoma, scar or the distorted region of tissue in all cases (100%), and there was no evidence of migration on the post-biopsy findings.

목적: 유방병변의 초음파 유도하 맘모톰 절제 생검 후 외과용 표식자(clip) 삽입의 결과와 유용성 알아보고자 하였다. 대상과 방법: 2003년 11월부터 2004년 6월까지 본원에서 맘모톰 절제 생검을 한 24예(평균연령; 46세, 평균 크기; 12.6 mm, 병리 조직검사 결과; 양성 19예, 악성 5예) 의 병변을 대상으로 저자들이 자체 제작한 바늘을 사용하여 외과용 티타늄 표식자를 병변 제거 부위에 삽입하였다. 표식자를 삽입하였던 24예 중 18예에서 초음파 추적 검사를 25회(1개월 이내; 13예, 6개월; 12예) 실시하였다. 총 24예에 대한 티타늄 표식자 삽입 성공율, 삽입 후 합병증과 18 예의 25회 추적 초음파 검사에서 표식자 확인의 용이성 및 명확도, 표식자 위치를 후향적으로 분석하였다. 결과: 총 24예 모두 목적한 위치에 표식자의 삽입에 성공하였으며(100%), 통증이나, 시술 부위의 감염은 없었으나 1예에서 큰 혈종(3.5 cm)을 형성하였다. 초음파 추적 검사에서 티타늄 표식자는 추적 기간(1개월 내; 85%, 6개월; 84%) 및 해부학적 구성 성분 부위(실질 내; 80%, 실질-지방 경계부; 90%)에 관계없이 밝은 에코의 선상 구조물로 명확히 관찰되었다. 추적 검사에서 혈종(85%)과 반흔(89%)이 있는 경우에도 표식자 발견이 용이하였고, 표식자는 전 예에서 병변, 혈종, 반흔, 왜곡 등의 소견 부위에서 위치하여 다른 부위로 이동되어 있는 경우는 없었다. 결론: 초음파 유도하 맘모톰 절제 후 티타늄 표식자 삽입은 적은 비용으로 간편하게 시술할 수 있었고, 100% 성공율을 보였으며 동반된 합병증이 거의 없었다. 또한 추적 검사에서 모든 표식자가 잘 보였으며, 절제 생검 부위 내에 위치하여 임상적 적용에 유용하였다.

Keywords

References

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