Biopsie excisionnelle stereotaxique de lesions mammaires non palpables par la techique abbi

Objectives introduce briefly the classification of the American College of Radiology for non palpable breast lesions and the different techniques used for stereotactic breast biopsies. Evaluate the efficiency of the ABBI technique for non palpable breast lesions and its role in breast biopsies, on the base of 67 cases.Subjects and method Sixty-seven stereotactic excisional biopsies on dedicated prone tables were performed using the ABBI technique for 21 probably benign and 46 indeterminate non palpable breast lesions seen on mammograms. Twenty-five cases were densities, architectural distorsions or radial scars, and 42 were microcalcifications.Results In our hands, the technique is 100% specific and sensitive. This high percentage of success is related to a team work between radiologists, surgeons or gynecologists.The specimen represent the whole lesion. Ductal carcinoma in situ [DCIS] and atypic ductal hyperplasia [ADH] are diagnosed with accuracy. Twelve carcinomas are found, three of them DCIS. ADH was encountered in two cases.Complications are minor, hematomas of small and moderate volume were encountered in eight cases [12%].ABBI technique replaces surgical biopsies after wire hook localisation for solitary lesion smaller than two cm in diameter and stereotactic Tru-cut biopsies, even with vacuum aspiration, for small cluster of microcalcifications, architectural distorsion and radial scar, here the percentage of failure is higher. For malignant lesions, surgery must follow, even when the margins are free

Salpingographie selective et recanalisation tubaire transcervicale technique, indications, resultats

The aim of the study is to evaluate the efficacy of selective salpingography and fallopian tube recanalization as a diagnostic and therapeutic procedure when proximal tubal obstruction is present. Fifty-three procedures were performed between January 95 and March 98 in the Radiology Department of HoteI-Dieu de France Hospital, on 53 infertile women aged between 25 and 43 years. Unilateral or bilateral obstruction was documented on hysterosalpingogram or by laparoscopy. The technique consisted of a direct fallopian tube catheterization, under fluoroscopy using an hydrophilic guidewire. Water soluble contrast material was used. Eighty-eight tubes were evaluated [35 with bilateral and 10 with unilateral obstruction, 8 single tubes]. Recanalization was possible in 52 cases [97.5%].Twenty-nine patients were followed. Thirteeen pregnancies were reported [45%]. This pregnancy rate is however increased to 62% if we exclude the cases where other infertility problems coexisted. No complications occurred. Selective salpingography and fallopian tube catheterization is a non invasive successful technique that is extremely useful in the diagnosis and treatment of tubal obstruction in women with infertility problems. It can be performed immediately after an hysterosalpingogram when the fallopian tubes are not opacified