中国癌症杂志 ›› 2017, Vol. 27 ›› Issue (12): 940-945.doi: 10.19401/j.cnki.1007-3639.2017.12.004

• 论著 • 上一篇    下一篇

对比增强能谱乳腺X线摄影的辐射剂量分析

沈茜刚1,周良平1,郑晓静1,吴 坚1,谢 丽2,李瑞敏1,肖 勤1,顾雅佳1,彭卫军1   

  1. 1. 复旦大学附属肿瘤医院放射诊断科,复旦大学上海医学院肿瘤学系,上海200032 ;
    2. 复旦大学附属肿瘤医院肿瘤预防部,复旦大学上海医学院肿瘤学系,上海200032
  • 出版日期:2017-12-30 发布日期:2018-01-11
  • 通信作者: 周良平 E-mail:zhoulp-2003@163.com

Radiation dose analysis of contrast-enhanced spectral mammography

SHEN Xigang1, ZHOU Liangping1, ZHENG Xiaojing1, WU Jian1, XIE Li2, LI Ruimin1, XIAO Qin1, GU Yajia1, PENG Weijun1   

  1. 1. Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 2. Department of Cancer Prevention, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2017-12-30 Online:2018-01-11
  • Contact: ZHOU Liangping E-mail: zhoulp-2003@163.com

摘要: 背景与目的:对比增强能谱乳腺X线摄影(contrast-enhanced spectral mammography,CESM)是近几年推出的一项新技术,它是基于常规乳腺X线摄影的一项检查技术。该研究通过对低能图与CESM两种影像检查方法的平均腺体剂量进行比较,对CESM检查方法的辐射剂量进行分析。方法:收集143例临床可触及乳腺肿块的患者,根据腺体类型进行分类,其中脂肪型(a)7例,散在纤维腺体型(b)31例,不均匀致密型(c)76例,极度致密型(d)29例;根据病变部位进行分类,其中右侧乳腺肿块70例,左侧乳腺肿块64例,双侧乳腺肿块9例;年龄分布小于40岁有27例,41~50岁有51例,51~60岁有50例,61~70岁有15例。对患者进行划分,比较各腺体类型、健侧或患侧乳腺及不同年龄段的低能图与CESM两种影像检查方法的平均腺体剂量。结果:共计143例患者,CESM检查的AGD较低能图的AGD高26.22%,差异存在统计学意义(P<0.05)。不同乳腺腺体类型的CESM和低能图曝光剂量组内差异均有统计学意义(P<0.05);对CESM和低能图的曝光剂量组间比较时,a、b、c和d型腺体类型的AGD分别增加了26.05%、25.92%、26.82%和24.93%,可见c型腺体的AGD增幅最大,d型腺体的AGD增幅最少(P<0.05)。CESM检查时患侧乳腺的AGD较健侧乳腺的AGD高4.15%,差异有统计学意义(P<0.05)。各年龄段中CESM和低能图的AGD值组内、组间差异均有统计学意义(P<0.05),其中两个患者数较多的年龄段41~50岁、51~60岁的组间两两比较差异有统计学意义(P<0.05)。结论:CESM影像检查方法的辐射剂量略高于低能图,不同乳腺腺体类型、病变部位及年龄段之间均有差异,但仍是一种安全、可靠的检查技术,临床可根据实际需要开展应用。

关键词: 对比增强能谱乳腺X线摄影, 全数字化乳腺X线摄影, 平均腺体剂量, 辐射剂量

Abstract: Background and purpose: Contrast-enhanced spectral mammography (CESM) is a new technology introduced in recent years, and a technique based on conventional mammography. The radiation dose of the CESM was analyzed by comparing the average gland dose (AGD) of the low energy imaging and the CESM. Methods: A total of 143 patients with clinically palpable breast masses were enrolled in this study. The AGD of the two imaging methods were analyzed according to the type of breast glands (7 cases of almost entirely fatty type, 31 cases of scattered areas of fibroglandular density type, 76 cases of heterogeneously dense type, 29 cases of extremely dense type), lesion site (70 cases of right breast mass, 64 cases of left breast mass, 9 cases of bilateral breast mass) and age distribution (<40 years in 27 cases, 41-50 years in 51 cases, 51-60 years in 50 cases, 61-70 years old in 15 cases). Results: The AGD of
CESM of all the 143 patients was higher (26.22% ) than that of low energy imaging (P<0.05). The AGD of the four gland types of a, b, c and d in the CESM group were higher than those in the low energy imaging group by 26.05%, 25.92%, 26.82% and 24.93% respectively. Therefore the AGD of c-type gland increased the most, whereas AGD of d-type gland increased the least (P<0.05). The AGD of the affected side breast (4.15%) was higher than that of the unaffected side breast (P<0.05). There were statistically significant differences between the two groups by age (41-50 years, 51-60 years) (P<0.05). Conclusion: Radiation dose of CESM is slightly higher than that of low energy imaging in general and differences by breast gland types, lesion site and age can be observed. However, CESM is still a safe and reliable diagnostic imaging technology and can be applied according to clinical needs.

Key words: Contrast-enhanced spectral mammography, Full field digital mammography, Average gland dose, Radiation dosage