全景数字乳腺X线摄影条件对致密型乳腺患者辐射剂量及图像质量的影响  

Influence of photographic conditions in full field digital mammography on radiation dose and image quality in patients with dense breasts

作　　者：陈晓[1] 曹国全[1] 林晓敏[1] 陈勇春[1] 王美豪[1] 傅钢泽[1] 

机构地区：[1]温州医科大学附属第一医院放射科,325006

出　　处：《中华放射学杂志》2017年第7期529-534,共6页Chinese Journal of Radiology

基　　金：温州市科技计划项目（Y20160157）

摘　　要：目的探讨对致密型乳腺患者行全景数字乳腺X线摄影（FFDM）检查，摄影条件对辐射剂量及图像质量的影响。方法（1）临床试验：回顾性分析行FFDM检查的女性致密型乳腺患者100例370幅图像，钼-铑（Mo-Rh）组合277幅，钨-铑（W-Rh）组合93幅。行常规摄影，自动曝光。记录腺体压迫厚度、靶-滤过（T-F）组合方式、管电压、管电流、平均腺体剂量（AGD）和表面入射剂量（ESE）。（2）模体实验：用不同厚度的聚甲基丙烯酸甲酯有机玻璃（PMMA）模拟标准乳腺，再将铝片置于PMMA板中模拟致密型乳腺。采用Mo-Rh、W-Rh组合对厚度为68 mm和58 mm的致密型模体分别进行自动曝光和手动曝光，记录腺体压迫厚度、T-F、管电压、管电流、AGD和ESE，计算ESE与AGD的比值（ESE/AGD），并通过软件得出逆影像质量指数（IQFInv）。临床试验部分，采用多因素方差分析评价不同腺体压迫厚度和管电流对AGD和ESE的影响，采用Pearson相关及回归分析评价不同腺体压迫厚度对ESE/AGD的影响。模体实验部分，采用Pearson相关分析评价不同管电压和管电流对AGD、ESE、ESE/AGD的影响，采用单因素方差分析评价不同管电压和管电流对IQFInv的影响。结果（1）临床试验：采用Mo-Rh和W-Rh组合，随腺体压迫厚度增加，ESE/AGD值均升高，ESE/AGD和腺体压迫厚度具有相关性，r值分别为0.980、0.956，P均〈0.01。W-Rh和Mo-Rh组合下，不同腺体压迫厚度间的AGD和ESE差异均有统计学意义（P均〈0.05）。无论采用W-Rh组合还是Mo-Rh组合，不同管电流间的AGD和ESE差异均有统计学意义（P〈0.05）。（2）模体实验：对致密型模体手动调整曝光参数，无论采用W-Rh还是Mo-Rh组合，随管电流和管电压的增加，IQFInv呈不同程度增加，不同管电流间IQFInv的差异有统计学意义（P均〈0.05）。管电流和管电压与ESE和AGD均呈正相关（P均〈0.05）。�ObjectiveTo investigate the radiation dose delivered to the patients with dense breasts and the influence of photographic conditions on image quality in full field digital mammography （FFDM）.Methods（1） Clinical test： we analyzed the compression thickness of breasts, Target-filter（T-F）, voltage current （kV）, tube current （mAs）, average glandular dose （AGD） and entrance surface dose （ESE） of 100 patients （a total of 370 images, 277 images of Molybdenum-Rhodium（Mo-Rh）and 93 images of Wolfram-Rhodium （W-Rh）） who underwent examinations in mode of automatic exposure by FFDM with dense breasts. （2） Phantom experiments： placed the Aluminium plate on different thickness of polymethyl methacrylate （PMMA） plates to simulate the dense breasts. 68 mm phantom was used to simulate photographic condition of W-Rh and 58 mm to Mo-Rh. The two groups of dense phantom were exposed automatically and manually. The parameters were recorded for each exposure including the compression thickness of breasts, T-F, kV, mAs, AGD, ESE, the calculation of the ratio between ESE and AGD （ESE/AGD）. The image quality figure inverse （IQFInv） was obtained by software. To the clinical test, used multiple factors of variance to analyze the influence of compression thickness and mAs on AGD and ESE, Pearson correlation and regression to analyze the influence of compression thickness on ESE/AGD. To the phantom experiments, used Pearson correlation to analyze the influence of kV and mAs on AGD, ESE and ESE/AGD, single factor of variance to analyze the influence of kV and mAs on IQFInv.Results（1） Clinical test： to Mo-Rh and W-Rh, with the increase of compression thickness, ESE/AGD was increased significantly. Compression thickness had linear relationship with ESE/AGD. Pearson correlation coefficients of W-Rh and Mo-Rh were 0.956 and 0.980, respectively（P〈0.01）. The effects of compression thickness and mAs on AGD and ESE were statistically significant （P〈0.05） in the two groups. （

关 键 词：辐射剂量 乳房X线摄影术 对比研究 

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