保乳术后乳腺X线摄影内外侧斜位改良投照方法研究  

Study on improved performance of mammographic medial-lateral oblique projections after breast conserving surgery

作　　者：刘莎 曹崑[1] 马亚光[1] 赵红梅[1] LIU Sha;CAO Kun;MA Yaguang;ZHAO Hongmei(Department of Radiology,Peking University Cancer Hospital&Institute,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,北京100142

出　　处：《实用放射学杂志》2022年第4期656-660,共5页Journal of Practical Radiology

摘　　要：目的探讨保乳术后乳腺X线摄影内外侧斜(MLO)位改良投照方法及其临床应用价值.方法对47例需进行常规乳腺X线复查的保乳手术后患者,采用自身对照实验,以对比改良MLO位投照(优化旋转体位)与常规投照位的差异.由2名技师对改良MLO位和常规MLO位图像进行双盲3分制评分(乳头是否在切线位、腺体暴露程度、腺体对比度质量),并根据患者术侧乳腺不同切口位置进行分组.采用配对Wilcoxon秩和检验对改良MLO位和常规MLO位图像评分进行统计学分析.结果改良MLO位的上述3项图像评分(2.8分、2.6~2.9分、2.8~2.9分)对比常规MLO位(1.6~1.9分、2.1~2.3分、2.6~2.7分)有明显提高,差异有统计学意义(P<0.05).对切口位置为外上方的病例,改良MLO位的乳头切线位显示及腺体暴露程度评分均高于常规MLO位(分别为2.8分vs1.7~1.8分,2.5~2.9分vs1.9~2.1分,P<0.001);对切口位置为内上方的病例,乳头切线位评分从1.4分提高到2.7~2.8分(P<0.001).结论在保乳术后患者的乳腺X线检查中,通过优化旋转体位的改良MLO位投照方法可显著提高图像质量,提供更丰富有效的诊断信息.Objective To explore a modified method of medial-lateral oblique(MLO)projection in mammography after breast conserving surgery,and to evaluate the clinical application value of the MLO method.Methods Forty-seven patients with history of breast conserving surgery and with routine follow-up for mammography examinations were enrolled in this study.Self-controlled experiment was carried to compare the differences between the modified MLO projection position(optimized rotating body position)and the traditional position.Paired MLO images were blindly evaluated by two radiologic technologists using a three-point score including the tangent position of the nipple,breast tissues exposure,and the quality of glandular image contrast.Patients were divided into subgroups by position of breast incision.Paired Wilcoxon Signed Ranks test was used to compare differences in mammography between modified MLO position and traditional MLO position.Results The modified MLO position showed significantly increased three point scores compared with traditional MLO position(P<0.05,2.8,2.6-2.9,2.8-2.9 vs 1.6-1.9,2.1-2.3,2.6-2.7,respectively).For patients with upper-lateral incisions,the modified MLO position showed significantly improved scores in the tangent position of the nipple and breast tissues exposure compared with that in traditional MLO position(P<0.001,2.8 vs 1.7-1.8,2.5-2.9 vs 1.9-2.1’respectively).For upper-medial incisions,scores of the tangent position of the nipple were improved from 1.4 to 2.7-2.8(P<0.001).Conclusion For patients with breast conserving surgery,it is supposed that mammographic images with high quality be improved based on modified MLO position method,and rich information for diagnosis be provided.

关 键 词：乳腺X线摄影 投照体位 保乳手术 

分 类 号：R814.41[医药卫生—影像医学与核医学] R655.8[医药卫生—放射医学]