数字乳腺断层融合X线成像中平均腺体剂量与乳腺密度、压迫厚度的关系  

Relationship between AGD_(DBT) and breast density or compressed breast thickness

作　　者：杨蕾[1] 宋俊峰[1] 李静 周纯武[1] 

机构地区：[1]国家癌症中心中国医学科学院北京协和医学院肿瘤医院影像诊断科,北京100021

出　　处：《放射学实践》2017年第5期494-497,共4页Radiologic Practice

摘　　要：目的:探讨数字乳腺断层融合X线成像(DBT)中平均腺体剂量(AGD)与乳腺密度、压迫厚度的关系。方法:搜集在DBT Combo模式[即DBT和全视野数字化乳腺摄影(FFDM)分别在同一乳腺、在同一压迫厚度下进行摄影]下行双侧乳腺摄影的女性患者271例。分析共542幅DBT和542幅FFDM的单侧乳腺头尾位图像。结果:(1)压迫厚度与AGD_(DBT)呈正向较强相关(r=0.920,P<0.001),乳腺密度与AGD_(DBT)呈正向较弱相关(r=0.263,P<0.001)。压迫厚度和乳腺密度分别是AGD_(DBT)的独立影响因素(B_(压迫厚度)=0.046,B_(乳腺密度)=0.084,P<0.001)。压迫厚度对AGD_(DBT)的影响较乳腺密度大(压迫厚度、乳腺密度的标准化系数分别为0.940、0.143)。(2)压迫厚度与△AGD(AGD_(DBT)减去AGD_(FFDM))呈负向较弱相关(r=-0.287,P<0.001),乳腺密度与△AGD呈负向中等相关(r=-0.616,P<0.001);乳腺密度和压迫厚度分别是△AGD的独立影响因素(B_(压迫厚度)=-0.012,B_(乳腺密度)=-0.219,P<0.001);乳腺密度对△AGD的影响较压迫厚度大(压迫厚度、乳腺密度的标准化系数分别为-0.580、-0.366)。(3)在乳腺密度>75%且压迫厚度为56~75mm和76~95mm时,AGD_(DBT)均值低于AGD_(FFDM),差异有统计学意义(P<0.05)。在乳腺密度为25%~50%且压迫厚度为76~95mm时,AGD_(DBT)均值与AGD_(FFDM)相仿(P>0.05)。在乳腺密度为51%~75%且压迫厚度为56~75mm时,AGD_(DBT)均值与AGD_(FFDM)相仿(P>0.05)。在其他乳腺密度和压迫厚度分层中(压迫厚度均≤95mm),AGD_(DBT)均值高于AGD_(FFDM),差异有统计学意义(P<0.05)。结论:AGD_(DBT)与乳腺密度、压迫厚度呈正相关,压迫厚度对AGD_(DBT)的影响更大。△AGD与乳腺密度、压迫厚度呈负相关;乳腺密度对△AGD的影响更大。在乳腺密度>75%且压迫厚度为56~95mm时,AGD_(DBT)均值低于AGD_(FFDM);在其他乳腺密度及压迫厚度分层(压迫厚度均≤95mm)中,AGD_(DBT)均值高于或等于AGD_(FFDM)。Objective：To discuss the relationship between AGDDBT and breast density or compressed thickness. Methods：271 female patients who had bilateral mammography under the mode of DBT combo （taking images of the same breast and same compressed thickness with DBT and FFDM） in our hospital were included. 542 images of unilateral breast cranio-caudal view with DBT and 542 images of unilateral breast eranio-caudal view with FFDM were analyzed （AGD, breast density and compressed thickness）. Results：Compressed thickness and AGDDBT had a strong positive correlation （r = 0. 920,P 〈0. 001）. Breast density and AGDDBT had a weak positive correlation （r = 0. 263,P 〈0. 001）. Compressed thickness and breast density both independently influenced AGDDBT（Bcompressed thickness= 0. 046,Bbreast density=0. 084,P〈0. 001）. Compressed thickness had a greater influence on AGDDBT than did breast density （std Bcompressed thickness= 0. 94,std Bbreast density= 0. 143）. Compressed thickness and △AGD （AGDDBT minus AGDFFDM） had a weak negative correlation （r = - 0. 287,P 〈 0. 001）. Breast density and △AGD had a medium-strong negative correlation （r =- 0. 616,P 〈0. 001）. Breast density and compressed thickness both independently influenced △AGD （Bcompressed thickness=-0. 012,Bbreast density= - 0.219, P〈0. 001）. Breast density had a greater influence on △AGD than did compressed thickness （std Bcompressed thickness=-0. 366,stdBbreast density= 0. 580）. When breast density 〉 75% and compressed thickness was 56 -75mm or 76 -95mm,the mean value of AGDDBT was lower than that of AGDFFDM,thus the difference was statistical siginificant （P 〈0.05）. When 25%≤ breast density ≤ 50% and compressed thickness was 76 - 95mm,the mean value of AGDDBT was similar to that of AGDFFDM （P 〉 0.05）. When 50 %〈 breast density ≤75 % and compressed thickness was 56 - 75mm, the mean value of AGDDBT was similar to that of AGDFFDM （P〉 0.05）. In the other groups with different breast densi

关 键 词：数字乳腺断层融合X线成像 放射摄影术 乳腺 平均腺体剂量 乳腺密度 压迫厚度 

分 类 号：R730.44[医药卫生—肿瘤] R737.9[医药卫生—临床医学]