对比增强乳腺X线摄影与全视野乳腺X线摄影辐射剂量

目的 观察对比增强乳腺X线摄影（CEM）与全视野乳腺X线摄影（FFDM）乳腺辐射剂量及其与腺体压迫厚度的相关性。方法 采用模体实验对比同机FFDM及CEM 2种模式下平均腺体剂量（AGD）。102例乳腺疾病患者接受CEM（CEM组）,另104例接受同机FFDM（FFDM组）,记录2组AGD及腺体压迫厚度;按美国放射学院（ACR）第5版乳腺影像报告数据系统（BI-RADS）标准区分致密腺体及非致密腺体,比较组间及不同类型腺体间AGD和腺体压迫厚度差异,分析AGD与腺体压迫厚度的相关性。结果 模体实验结果显示低能CEM与FFDM的AGD相仿。CEM组非致密腺体22例,致密腺体80例;FFDM组非致密腺体39例,致密腺体65例;2组腺体压迫厚度差异无统计学意义（U=4 823.50,P>0.05）。CEM组总AGD与FFDM组差异无统计学意义（U=5 249.50,P>0.05）,低能CEM的AGD低于FFDM组（U=2 111.00,P<0.05）。FFDM组AGD（r=0.45）及CEM组总AGD（r=0.79）与腺体压迫厚度均呈正相关（P均<0.05）。对非致密腺体,CEM组AGD高于FFDM组（U=266.00,P<0.05）,而对致密腺体,CEM组AGD与FFDM组AGD差异无统计学意义（U=2 223.00,P>0.05）。FFDM组致密腺体AGD高于非致密腺体（U=846.50,P<0.05）,而CEM组致密腺体与非致密腺体AGD差异无统计学意义（U=690.50,P>0.05）。结论 CEM总辐射剂量与FFDM相仿;压迫后腺体厚度越薄,辐射剂量越低;CEM对致密型腺体更具优势。

Comparison on radiation dose of contrast-enhanced mammography and full-field digital mammography

Objective To compare breast radiation dose between contrast-enhanced mammography (CEM) and full-field digital mammography (FFDM), and to explore the correlation of breast radiation dose with gland compression thickness. Methods The average gland dose (AGD) of FFDM and CEM were compared through phantom experiment on the same mammography device. Totally 102 patients with breast disease underwent CEM (CEM group), while other 104 underwent FFDM (FFDM group) on the same machine, and AGD and gland compression thickness were recorded. Based on the 5th breast imaging-reporting and data system (BI-RADS) of American college of radiology (ACR), the breasts were divided into dense glands and non-dense glands. The differences of AGD and gland compression thickness were compared between 2 groups and among different types of glands, and the correlations of AGD and gland compression thickness were analyzed. Results AGD of low-energy CEM and FFDM were similar in phantom experiment. There were 22 non-dense glands and 80 dense glands in CEM group, 39 non-dense glands and 65 dense glands in FFDM group. No significant difference in gland compression thickness was found between 2 groups (U=4 823.50, P>0.05). There was no statistical difference of the AGD in CEM group and AGD of FFDM group (U=5 249.50, P>0.05), while AGD of low energy CEM was lower than that of FFDM group (U=2 111.00, P<0.05). Both AGD of FFDM group (r=0.45) and total AGD in CEM group (r=0.79) were positive correlated with the thickness of gland compression (both P<0.05). For non-dense glands, the AGD of CEM group was higher than AGD of FFDM group (U=266.00, P<0.05), while for dense glands, there was no statistical difference of ADC between CEM and FFDM (U=2 223.00, P>0.05). The AGD of dense glands was higher than that of non-dense glands in FFDM group (U=846.50, P<0.05), while there was no significant difference in AGD between dense and non-dense glands in CEM group (U=690.50, P>0.05). Conclusion The overall ADC of CEM was comparable to that of FFDM. The thinner the gland compression thickness is, the lower the radiation dose is. CEM had more advantageous for dense breasts than for non-dense glands.