RESUMO
OBJETIVO: O objetivo deste estudo foi desenvolver um padrão de avaliação diagnóstica pela Core biopsy com agulha de 16G em lesões mamárias. Utilizando critérios ecográficos padronizados e relacionando os resultados ao tamanho das lesões investigadas e avaliando o número ideal de fragmentos a serem colhidos. MÉTODOS: Estudo prospectivo de maio de 2004 a setembro de 2005 em 79 pacientes com lesões incluídas nas categorias 2, 3, 4 e 5, segundo Bi-RADS® US, realizando Core Biopsy com agulha de 16G, retirando-se cinco fragmentos numerados e colocados individualmente em frascos com formol a 10 por cento. RESULTADOS: De 84 biópsias realizadas houve 81 diagnósticos conclusivos (96 por cento), com 43 malignos (51 por cento) e 38 benignos (45 por cento). A eficácia da Core biopsy aumenta com o número de amostras colhidas: com uma amostra é de 95,24 por cento,duas amostras 96,93 por cento; três amostras 98,8 por cento; quatro amostras 98,81 por cento; cinco amostras 100 por cento. CONCLUSÃO: A retirada de três fragmentos foi suficiente para um resultado satisfatório.
OBJECTIVE: The objective of this study was to develop a standard diagnostic evaluation with 16G core-needle biopsy for breast lesions. We evaluated the ideal number of fragments using standard ultrasound criteria based on the previous results obtained on the size of the lesions. MEHTODS: A prospective study was carried out, from may 2004 to September 2005, in 79 patients with lesions that included categories 2,3,4 and 5, according to BIRADS -USTM using 16G core biopsy needle. We took up 5 pieces numbered and placed individually in vials with 10 percent formalin. RESULTS: In 84 biopsies performed there were 81 conclusive diagnoses (96 percent), with 43 malignant results (51 percent) and 38 benign results (45 percent). The effectiveness of the core biopsy increased with the sample numbers: one sample is 95.24 percent accurate; two samples reach 96.93 percent; three samples reach 98.8 percent; four samples reach 98.81 percent, and finally, five samples reach 100 percent accuracy. CONLCUSION: the resection of three fragments was sufficient for a satisfactory result.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Neoplasias da Mama/patologia , Neoplasias da Mama , Ultrassonografia de Intervenção , Biópsia por Agulha , Desenho de Equipamento , Agulhas , Estudos Prospectivos , Adulto JovemRESUMO
OBJECTIVE: The objective of this study was to develop a standard diagnostic evaluation with 16G core-needle biopsy for breast lesions. We evaluated the ideal number of fragments using standard ultrasound criteria based on the previous results obtained on the size of the lesions. METHODS: A prospective study was carried out, from may 2004 to September 2005, in 79 patients with lesions that included categories 2,3,4 and 5, according to BIRADS -USTM using 16G core biopsy needle. We took up 5 pieces numbered and placed individually in vials with 10% formalin. RESULTS: In 84 biopsies performed there were 81 conclusive diagnoses (96%), with 43 malignant results (51%) and 38 benign results (45%). The effectiveness of the core biopsy increased with the sample numbers: one sample is 95.24% accurate; two samples reach 96.93%; three samples reach 98.8%; four samples reach 98.81%, and finally, five samples reach 100% accuracy. CONCLUSION: the resection of three fragments was sufficient for a satisfactory result.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Ultrassonografia de Intervenção , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Desenho de Equipamento , Feminino , Humanos , Pessoa de Meia-Idade , Agulhas , Estudos Prospectivos , Adulto JovemRESUMO
OBJECTIVES: To compare liver intraoperative ultrasonography (IOU), computed tomography (CT), preoperative ultrasonography (USG), and intraoperative inspection and palpation in the detection of hepatic lesions in patients with abdominal tumors. METHODS: This was a prospective study including 60 patients with abdominal tumors evaluated by USG, CT, inspection and palpation, and hepatic IOU during exploratory laparotomy. Sensitivity, specificity, and positive and negative predictive values for all methods were calculated. Agreement of methods with histopathologic results was calculated by kappa statistics and the Spearman coefficient. RESULTS: Of the 60 patients, 49 (81.6%) had positive findings for hepatic lesions. Lesions could not be counted in 3 patients. The 46 remaining cases were diagnosed by histologic examination. Sensitivity, specificity, and positive and negative predictive values were 42.9%, 88.9%, 90%, and 40% for USG; 59.5%, 77.8%, 86.2%, and 45.2% for CT; 69.0%, 88.9%, 93.5%, and 55.2% for inspection and palpation; and 90.5%, 77.8%, 90.5%, and 77.8% for IOU, with histologic examination used as a criterion standard. Fair to moderate agreement was found for USG, CT, and inspection and palpation (kappa = 0.24, 0.31, and 0.49, respectively). Substantial agreement was found for IOU (kappa = 0.68). Changes in surgical strategy were made in 19 (41.3%) of the 46 cases with positive findings. CONCLUSIONS: High sensitivity associated with substantial agreement with histopathologic findings shows that IOU is an indispensable evaluation method for hepatic screening in patients with abdominal tumors who undergo laparotomy and should become a routine procedure wherever available.