乳腺钙化病灶X线摄影复查及钩丝定位中减少辐射损伤的方法研究

目的：探讨乳腺钙化性病灶在数字X线摄影复查及三维钩丝定位过程中，有效减少辐射损伤的方式。 方法：收集2015年4月—2016年4月在我院检查患有乳腺钙化病灶的24例女性患者，所有患者第一次进行乳腺X线摄影检查均使用自动曝光模式（AEC），随后在3周内进行三维钩丝定位穿刺。行钩丝定位时，X线钙化灶定位片摄影采用手动曝光模式（MEC），在分别固定管电压或管电流值不变的情况下，按一定比率调低相应的管电流或管电压，进行曝光，分别记录两种曝光条件下的平均腺体剂量（AGD）及入射剂量（ESD），比较两组图像钙化灶的显示情况，三维钩丝定位随后的操作均在管电流下调30%的条件下进行。 结果：在管电流与管电压分别调低不同比率的情况下，AGD与ESD值均有不同程度下降；在管电流下降30%以内，管电压下降15%以内时，两组图像钙化灶显示无明显差异；低剂量摄影条件下进行的三维钩丝穿刺，穿刺针头部均距离目标钙化点<2 cm，后续手术效果满意。 结论：在一定范围内调低管电流或管电压进行乳腺X线摄片，可有效降低辐射损伤，对于钙化灶的显示则无明显影响，BI-RADS分类无差异；低剂量X线摄片完全可以满足三维钩丝定位的需要。

Reducing radiation damage methods in snagging positioning and Breast X-ray photography calcified lesions

Objective:This study aims to identify an effective way to reduce radiation damage in Calcified lesions of the breast by retaking digital X-rays and 3-dimensional positioning hook wire. Methods:The imaging data were collected from 24 females with breast calcified lesions admitted in our hospital between April 2015 and April 2016. All patients first breast X-rays were taken under the automatic exposure mode (AEC). Three weeks later, they received the three-dimensional positioning snagging puncture. During the procedure, the X-ray calcification Photography geopositioning sheet was set in manual exposure mode (MEC). Under a fixed tube voltage or tube current the operator manually lower the tube current or tube voltage at a certain ratio for exposure . Relative data were recorded in both the average glandular dose exposure condition (AGD) and the entrance dose (ESD) to compare the calcification. The following three-dimensional positioning snagging was operated withthe tube current lowered 30%. Results:In the case of that the tube current and tube voltage were lowered at different ratios, AGD and ESD values decreased in varying degrees; when the tube current drops 30% or less while the tube voltage drops less than 15%, the calcification lesions on the images showed no significant difference. The three-dimensional photographic snagging puncture at a low dose condition, with the needle pointing to and from the target calcification <2 cm, brings out satisfied surgical results. Conclusions:To reduce the tube current or tube voltage to a certain degree while taking breast X-rays, it can effectively reduce the radiation damage yet show no significant effect on the lesions, or any difference on BI-RADS classification. Thus, low-dose X-ray radiography can fully meet the needs of snagging three-dimensional positioning.