Ib Daim Ntawv Qhia Txog Kev Xaiv thiab Kev Tshuaj Xyuas Daim Ntawv Thov Kev Ntsuam Xyuas Ntawm Core Breast Biopsy Needles

https://www.mayoclinic.org/tests-procedures/breast-biopsy/about/pac-20384812

Abstract:

Tau ntsib nrog cov dazzling array ntawm core mis biopsy koob qauv thiab hom, cov kws kho mob yuav ua li cas xaiv qhov zoo tshaj plaws? Kab lus no yog npaj los muab cov lus qhia txog kev xaiv tswv yim. By analyzing lesion characteristics (size, depth, nature), guidance modalities (ultrasound, mammography, MRI), patient factors (age, breast density, presence of implants), and operator preference, it compares the pros and cons of different needle types-from manual semi-automatic needles and automatic spring-loaded guns to vacuum-assisted excision tshuab. Qhov no pab cov neeg nyeem tsim lub hauv paus meej rau kev xaiv koob.

Cov ntsiab lus tseem ceeb:

Hauv kev sib ntaus sib tua tiv thaiv kab mob ntawm lub mis, lub hauv pauslub mis biopsy koobyog tus kws kho mob feem ntau "pob phom." Txawm li cas los xij, qhov riam phom no tsis zoo ib yam. Los ntawm 14G mus rau 18G calibers, 20mm mus rau 22mm pov qhov ntev, phau ntawv ua rau lub siab tsis siv neeg tua, thiab lub peev xwm muaj zog ntawm lub tshuab nqus tsev- pab txiav tawm- txawv cov qauv sib txawv sib txawv nyob rau hauv ib puag ncig sib ntaus sib tua. Yuav ua li cas ib tug ua tiav "paub koj tus kheej, paub koj tus yeeb ncuab, thiab yeej ib puas battles" nyob rau hauv no kev xaiv riam phom? Kab lus no piav qhia txog qhov ua tau zoo rau kev xaiv koob.

Kauj Ruam Ib: Paub Koj Tus Yeeb Ncuab - Kev Ua Phem Txhaum Cai Tus Cwj Pwm dictate Tactics

Qhov xwm ntawm qhov txhab yog thawj qhov kev txiav txim siab ntawm kev xaiv koob.

• Loj -forming lesions:​ Rau qhov zoo-circumscribed, kuj mos mos (piv txwv li, fibroadenomas), standard 14G los yog 16G tsis siv neeg caij nplooj ntoos hlav- loaded biopsy koob yog txaus. Ib qho kev tua ib leeg feem ntau ua rau cov ntaub so ntswg txaus siab.
• Microcalcifications:Qhov no nthuav tawm qhov kev sib tw. Microcalcifications feem ntau tawg thiab nyuaj. Ntawm no, Lub Tshuab Nqus Tsev-Assisted Breast Biopsy (VABB) yog thawj qhov kev xaiv. Nws lub zog tsis zoo siab rub cov calcifications rau hauv qhov kev txiav txim siab, tso cai rau kev txiav cov rotary kom sau ntau cov ntaub so ntswg, txhim kho cov txiaj ntsig zoo. Ib txwm caij nplooj ntoos hlav-loaded koob feem ntau plam tawm ntom calcifications los yog fragment cov ntaub so ntswg core.
• Cystic - cov kab mob loj:​ Rau cov phiaj xwm khoom ntawm lub cyst phab ntsa, ua qhov tseem ceeb ntawm cov koob uas tso cai pom qhov pom tseeb ntawm rab koob hauv qab ultrasound, xws li semi- tsis siv neeg koob nrog lub tes tsho coaxial. Qhov no ua kom yooj yim lub hom phiaj ntawm cyst phab ntsa tom qab tshem tawm cov kua dej.
• Qhov tob thiab qhov chaw:Rau qhov txhab tawv nqaij, koob nrog luv luv luv yog qhov zoo dua. Rau cov kab mob sib sib zog nqus mus rau pectoralis fascia los yog ze rau ntawm daim tawv nqaij, ceev faj xam ntawm rab koob qhov kev mus los ntawm qhov deb yog yuav tsum tau kom tsis txhob ua puas lub pleura los yog nkag mus rau ntawm daim tawv nqaij. Nyob rau hauv cov ntaub ntawv no, phom biopsy nrog adjustable pov lengths los yog manually tswj semi- tsis siv neeg koob muaj ntau dua qhov zoo dua.

Kauj Ruam 2: Xaiv Koj Qhov Kev Sib Tw Sib Tw - Qhov cuam tshuam ntawm cov duab taw qhia Modality

• Kev taw qhia Ultrasound:Qhov no yog txoj hauv kev zoo tshaj plaws thiab yooj yim. Txij li thaum lub koob tip trajectory yog pom nyob rau hauv tiag tiag - sij hawm, yuav luag tag nrho cov core biopsy koob siv tau. Cov kws kho mob tuaj yeem txiav txim siab txoj haujlwm ntawm rab koob raws li echogenicity thiab kho cov kev taw qhia yooj yim.
• Stereotactic Mammography Cov Lus Qhia:Feem ntau siv rau localizing microcalcifications lossis architectural distortion pom ntawm ultrasound. Qhov xwm txheej no feem ntau xav tau kev mob siab rau ntev - muab cov koob tshuaj biopsy nrog cov cim taw qhia kom raug suav qhov tob hauv qab compression. Lub tshuab nqus tsev-pab pawg tswj hwm thaj chaw no.
• MRI Cov Lus Qhia:Qhov no yog qhov feem ntau technically demanding thiab complex modality. Tag nrho cov cuab yeej nkag mus rau hauv MRI suite yuav tsum tsis yog -ferromagnetic. Yog li ntawd, MRI-cov koob tshuaj biopsy tau siv tau zoo tshaj- feem ntau yog ua los ntawm titanium alloy lossis siab -lub zog polymers- yog qhov yuav tsum tau ua. Tsis tas li ntawd, vim lub sij hawm scan ntev thiab txwv tus neeg mob qhov chaw, cov txheej txheem nyuaj. Cov tshuab nrog lub tes tsho coaxial thiab lub peev xwm hauv cheeb tsam raug pom zoo kom ua kom yooj yim rau kev ua haujlwm.

Kauj Ruam 3: Paub Koj Tus Kheej - Tus Neeg Ua Haujlwm Kev Paub thiab nyiam

• Novices:​ Nws raug pom zoo kom pib nrog lub caij nplooj ntoos hlav tsis siv neeg -loaded biopsy phom. Lawv yog standardized; yooj yim aim thiab rub tus txhais kom tiav sampling. Txoj kev kawm nkhaus luv luv, txawm hais tias kev hloov pauv me ntsis txwv los ntawm qhov muab pov tseg.
• Proficient Operator:​ Muaj peev xwm tuav tau ib nrab - tsis siv neeg lossis phau ntawv biopsy koob. Cov no tso cai rau tus kws kho mob manually ua ntej lub taub hau mus rau qhov mob ntawm ntug ua ntej firing lub sab hauv txiav stylet, ua kom "sib cais" tswj. Qhov no tshwj xeeb tshaj yog muaj kev nyab xeeb rau cov kab mob nyob ze ntawm thaj chaw txaus ntshai.
• Cov neeg ua haujlwm siab tshaj plaws:Txaus siab rau VABB systems. Txawm hais tias cov khoom siv kim thiab cov kauj ruam ntau dua, ib qho kev ntxig ib zaug tuaj yeem sau ntau lub cores lossis txawm tias ua tiav kev txiav txim siab, muab kev ua haujlwm siab hauv cov xwm txheej nyuaj.

Kauj Ruam 4: Xav txog tus neeg mob - Tus kheej yam tsis tuaj yeem tsis quav ntsej

• Lub mis Thickness:Cov neeg mob uas nyias ob lub mis yuav tsum siv cov koob nrog luv luv.
• Kev pom ntawm Implants:Yuav tsum tau ceev faj heev. Ultrasound kev taw qhia nrog cov koob meej meej pom qhov pom tau zoo dua, siv cov blunt- cov lus qhia lossis cov koob retractable stylet kom txo tau qhov kev pheej hmoo ntawm cov hlab ntsha tawg. Lub tshuab nqus tsev-pab biopsy yuav ua rau muaj kev pheej hmoo ntxiv rau kev cog qoob loo vim yog nqus thiab yuav tsum tau soj ntsuam kom zoo.
• Coagulation Status:​ Rau cov neeg mob ntawm cov tshuaj tiv thaiv coagulants, thaum tsis muaj qhov tsis txaus ntseeg, cov koob tshuaj zoo dua qub (xws li 16G es tsis yog 14G) yuav tsum tau xaiv, nrog rau lub sijhawm ntev - txheej txheem compression.

Xaus

Kev xaiv ib rab koob ntawm lub mis biopsy yog tsis txhais tau tias yog ib qho yooj yim ntawm "kev noj dab tsi muaj." Nws yog qhov kev txiav txim siab dynamic- ua cov txheej txheem raws li plaub qhov loj me: qhov txhab, qhov duab, tus neeg teb xov tooj, thiab tus neeg mob. Tsis muaj "magic mos txwv" koob, tsuas yog cov cuab yeej uas haum rau qhov xwm txheej tam sim no. Tus kws saib xyuas lub mis zoo heev yuav tsum zoo li tus kws tshaj lij uas paub txog txhua lub cuab yeej hauv lawv cov khoom siv, paub thaum twg siv rauj thiab thaum twg yuav siv lub chisel. Tsuas yog li ntawd ib tus tuaj yeem taug kev ntau yam kev sib tw nrog kev yooj yim, ua kom muaj kev nyab xeeb thiab kev kuaj mob zoo.