乳腺癌筛查中乳腺X射线摄影两种标准体位及乳腺压迫厚度与平均腺体剂量的关系北大核心CSCD

为了使乳腺X射线摄影在乳腺癌筛查中的应用达到最优化,本文回顾性分析了在我院行乳腺X射线摄影和乳腺彩色多普勒超声检查,并取得病理结果的患者共132人、139个病灶,比较乳腺头尾位(craniocaudal view,CC)、内外侧斜位(medial lateral oblique view,MLO)、乳腺压迫厚度、乳腺密度与被检者接受的平均腺体剂量(average glandular dose,AGD)的关系及两种体位上病灶检出情况。结果显示:(1)乳腺压迫厚度及乳腺密度都是AGD的独立影响因素,并呈正相关,且乳腺压迫厚度对AGD的影响比乳腺密度大;(2)曝光参数管电压及管电流随着乳腺压迫厚度的增加有增加趋势,致使AGD增大;(3)同一乳腺CC及MLO的压迫厚度及AGD未发现特定规律,但均数±标准差CC位(2.49±0.84)>MLO位(2.27±0.81),且MLO比CC更易显示病灶。只拍摄乳腺MLO联合乳腺彩色多普勒超声检查具有很大优势,不仅保证了诊断需要,更降低了被检者的AGD值,且被检者乳腺压迫厚度及乳腺密度越大,AGD降低越多。

Relationship between two standard positions of mammography and breast compression thickness and average glandular dose in breast cancer screening

In order to optimize the application of mammography in breast cancer screening, we retrospectively analyzed 132 patients with 139 lesions who underwent mammography and breast color doppler ultrasonography in our hospital, and obtained pathological results(CC), medial lateral oblique view (MLO), breast compression thickness, breast density and the average glandular dose (AGD) received by the subjects, and the detection of lesions in two positions.The results showed that: (1) Both breast compression thickness and breast density were independent influencing factors of AGD, and were positively correlated; and the influence of breast compression thickness on AGD was greater than that of breast density. (2) The exposure parameters tube voltage and tube current tended to increase with the increase of breast compression thickness, resulting in the increase of AGD. (3) No specific pattern was found in the compression thickness and AGD of CC and MLO in the same breast, but the mean ± standard deviation at CC position was (2.49±0.84) which is greater than that of MLO position (2.27±0.81), and MLO was more prone to display lesions than CC. MLO combined with breast color Doppler ultrasound examination has great advantages, which not only ensures the need for diagnosis, but also reduces the AGD value of the subject. Moreover, the greater the thickness of breast compression and the density of the subject, the more the AGD decreases.