致密型乳腺在数字乳腺断层摄影中的辐射剂量分析

目的：通过分析致密型乳腺受检者在数字乳腺断层摄影（DBT）中的辐射剂量，探讨致密型乳腺辐射剂量的影响因素。方法：回顾性分析温州医科大学附属第一医院2019 年4月至2019 年12月行DBT检查的女性致密型乳腺受检者201例804组图像，每组图像包含DBT断层图和全景数字乳腺X线摄影（FFDM）二维图像。在后处理工作站记录每例受检者的摄影体位、乳腺压迫厚度、管电流、管电压、平均腺体剂量（AGD）和表面入射剂量（ESE）、乳腺截面大小和乳腺致密程度。采用多因素方差分析和Pearson相关分析研究致密型乳腺在DBT检查中辐射剂量的影响因素。结果：综合DBT和FFDM图像，不同乳腺压迫厚度、乳腺截面大小和乳腺致密程度对管电流、AGD、ESE的差异均有统计学意义（均P ＜0.05）；乳腺压迫厚度与ESE/AGD值具有高度相关性（均r =0.97，P ＜0.01）。结论：致密型乳腺受检者做DBT检查时，随着其乳腺压迫厚度、乳腺截面大小和乳腺致密程度的增加，辐射剂量会逐渐增高，尤其是ESE。

Radiation dose analysis of dense breast in digital breast tomosynthesis

Objective: To analyze the radiation dose of dense breast in Digital Breast Tomosynthesis (DBT) and to explore the affecting factors. Methods: A retrospective analysis was performed on 804 sets of images of 201 female dense breast patients undergoing DBT examination from April 2019 to December 2019. Each set of images included DBT tomography and full-field digital mammography (FFDM) images. Photographic position, breast compression thickness, tube current, tube voltage, average glandular dose (AGD) and entrance surface dose (ESE), breast section size and breast density of patients were recorded at the post-processing station. The influence factors of radiation dose of dense mammary gland in DBT examination were analyzed by multi-factor variance and Pearson correlation. Results: Combined with DBT and FFDM images, there was statistical difference (P<0.05) in tube current, AGD and ESE among different gland compression thickness, breast section size and breast density. The thickness of glandular compression was highly correlated with ESE/AGD (r=0.97,P<0.01). Conclusion: When DBT examination is performed on patients with dense breast, the radiation dose,especially ESE, will be gradually up with the increase of breast thickness, size and density.