保乳术后乳腺X线摄影头尾位投照方法改良及评价  

Improvement and evaluation of mammographic cranio-caudal projections for patients after breast-conserving surgery

作　　者：刘莎 曹崑[1] 马亚光[1] 赵红梅[1] LIU Sha;CAO Kun;MA Ya-guang(Department of Radiology,Peking University Cancer Hospital&Institute,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《放射学实践》2021年第7期885-888,共4页Radiologic Practice

摘　　要：目的:对保乳术后患者乳腺X线摄影头尾位(CC)投照方法进行改良并进行图像质量评价。方法:对2019年5月-2020年4月本院乳腺癌保乳手术后连续多次行乳腺X线检查的52例患者采用改良CC位投照,调阅每位患者改良前、后两次的乳腺X线CC位图像进行主观和客观两方面评价。主观评价由两名技师分别从乳头是否在切线位、腺体暴露程度、腺体对比度质量三方面进行评分,每项最高3分;客观评价采用后乳头线(PNL)测量值。改良前、后各项评分及测量值对比采用配对非参数检验。结果:主观评分显示:乳头是否在切线位在改良前评分1.7~1.8分,改良后2.6~2.7分,腺体暴露程度评分为改良前2.1分、改良后2.6分,改良后评分高于改良前,差异均有统计学意义(P<0.001),腺体对比度质量评分在改良前后差异无统计学意义。PNL测量值在改良后(50.2±16.2)mm较改良前(45.5±17.5)mm明显提高(P<0.001)。结论:针对保乳术后患者,改良CC位投照方法可明显提高乳腺X线图像质量。Objective:To improve the cranio-caudal(CC)projection method of mammography for patients after breast-conserving operation and to evaluate the image quality.Methods:From May 2019 to April 2020,52 patients who came for routine follow-ups after breast-conserving surgery received mammography examinations with a modified CC positioning(mainly targeting on the rotation position and compression method).Those with previous post-surgery mammograms were enrolled.Both the previous and the modified CC images for each patient were transferred to workstations.Images were evaluated from both objective and subjective aspects.The subjective evaluation referred to scoring by two technicians from three aspects:the tangency position of the nipple,visualization of the breast tissues,and the quality of image contrast with highest 3 points for each item.The objective evaluation referred to posterior nipple line(PNL)measurement.Paired nonparametric tests were used to compare the scores and measurements before and after the modification.Results:The subjective scores were 1.7~1.8 before and 2.6~2.7 afterwards for the nipple tangency position,2.1 before and 2.6 afterwards for visualization of breast tissues,2.7~2.8 before and 2.8~2.9 for the gland contrast quality.Significant improvements were seen in the former two aspects(P<0.001).The PNL after the modification(50.2±16.2 mm)was significantly higher than that of before modification(45.5±17.5 mm)(P<0.001).Conclusion:For patients after breast-conserving surgery,mammographic image quality can be improved with our modified CC projections.

关 键 词：乳腺肿瘤 乳腺X线摄影 摄影体位 保乳手术 

分 类 号：R816.4[医药卫生—放射医学] R737.9[医药卫生—临床医学]