超声与磁共振融合虚拟导航技术在乳腺病变定位中的初步研究

目的探讨超声融合磁共振成像（MRI）虚拟导航技术对仅MRI发现的乳腺病变定位的临床价值。 方法选取2016年6月至2018年12月于浙江大学医学院附属杭州市第一人民医院就诊的21例患者，均行超声及乳腺MRI检查，MRI发现22个超声上未显示的病灶且乳腺影像报告与数据系统（BI-RADS）评估为4类及以上，在俯卧位下行超声与MRI融合虚拟导航下定位，分别对病灶进行穿刺活检或定位后手术切除，与病理结果相对照，以及MRI术前/后对比，统计病变检出率，并分析此类病变的MRI特征及病理类型。 结果22个病灶中共计20个在虚拟导航下完成定位，检出率为91%。术后病理显示18个（90%）为良性病变，2个（10%）为恶性病变。22个病变中，MRI显示20个（91%）为非肿块样强化，仅2个（9%）为肿块型强化。 结论超声融合MRI虚拟导航可以有效提高超声隐匿性乳腺病变的检出率，通过超声引导下穿刺活检具有实时、便捷等特点，可在临床推广应用。

Localization of breast lesions using magnetic resonance imaging/ultrasound image fusion virtualnavigation technology: a preliminary study

Objective The purpose of our study was to evaluate the clinical utility of virtual navigation for magnetic resonance imaging(MRI)-detected incidental breast lesions.Methods Between June 2016 and December 2018,21 consecutive patients with 22 BI-RADS category 4 or above lesions that were detected on MRI but occult on second-look ultrasound(US)were enrolled in the study.All suspicious lesions were localized by using US/MRI fusion virtual navigation,and then underwent US-guided biopsy or surgical excision.The detection rate was calculated by comparing pre-/post-operation MRI and pathological results.The MRI features and pathological types of these lesions were analyzed.Results A total of 20 lesions were successfully localized using virtual navigation and underwent US-guided biopsy or localization,and the detection rate of virtual navigation was 91%.Eighteen(90%)lesions were proved to be benign lesions,and two(10%)proved to be malignant lesions by pathology.Of the 22 MRI-detected lesions,20(91%)manifested as non-mass enhancements and only two(9%)were masses.Conclusion Real-time US/MRI fusion virtual navigation can be an effective method for the evaluation of MRI-detected lesions that are not visible on US.