对比增强能谱乳腺摄影的辐射剂量影响因素分析  

Analysis the Influencing Factors of Radiation Dose with Contrast-Enhanced Spectral Mammography

作　　者：熊瑛 荣小翠[1] 高丽敏 李智岗[1] 王红光[1] XIONG Ying;RONG Xiaocui;GAO Limin(Department of Radiology,The Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei Province 050011,P.R.China)

机构地区：[1]河北医科大学第四医院放射科,石家庄050011 [2]河北省中医院导管室

出　　处：《临床放射学杂志》2023年第11期1730-1734,共5页Journal of Clinical Radiology

摘　　要：目的探讨对比增强能谱乳腺摄影(CESM)的辐射剂量影响因素。方法回顾性搜集200例患者的临床基本资料、乳腺摄影参数和诊断结果,包括:年龄、体重、月经状态、腺体厚度、压迫力度、平均腺体剂量(AGD)、腺体密度、病理学结果、BI-RADS分类结果等。使用单因素及多元逐步回归对各因素的影响进行统计分析。结果单因素分析显示除健患侧(U=-0.52,P=0.60),其余因素均对AGD有影响。多元逐步回归分析显示ADG随腺体厚度的增加而增加(B=0.053,P<0.05),随腺体密度的增加而减小(B=-0.083,P<0.05);随压迫力度的增加而减小(B=-0.016,P<0.05);阳极材料为钼靶时AGD大于铑靶(B=-0.380,P<0.05);内外侧斜位的AGD大于头尾位(B=0.077,P<0.05)。腺体厚度、靶材料、腺体密度、压迫力度、体位的标准回归系数分别为0.873、-0.273、-0.153、-0.148、0.064。结论腺体厚度、靶材料、腺体密度、压迫力度、体位均为影响AGD的独立因素。其中腺体厚度对AGD的影响最大。Objective To evaluate the influencing factors of radiation dose with contrast-enhanced spectral mammography(CESM).Methods The basic data,mammographic parameters and diagnostic results of 200 patients were collected retrospectively.Including patient age,weight,menstrual status,compressed breast thickness,compressed force,average gland dose(AGD),breast density,clinicopathological results,diagnostic results.The relationship of predictors and radiation dose was evaluated by univariate and multivariate analysis.Results Univariate analysis showed that the all factors except the unaffected and affected side(U=-0.52,P=0.60)were associated with radiation dose.Multivariate regression analysis showed positive associations between radiation dose and compressed breast thickness(B=0.053,P<0.05),an inverse association with breast density(B=-0.083,P<0.05)and compressed force(B=-0.016,P<0.05).When the anode material is molybdenum target,the AGD is higher than that of rhodium target(B=-0.380,P<0.001);The AGD of the medial lateral oblique position was higher than that of the cranio-caudal position(B=0.077,P<0.05).The standard coefficient of multivariate regression model of compressed breast thickness,target material,breast density,compressed force and examination position were 0.873,-0.273,-0.153,-0.148 and 0.064 respectively.Conclusion Multivariate regression analysis demonstrated a significant association between radiation dose and compressed breast thickness,target material,breast density,compressed force and examination position.The compressed breast thickness was the primary determinant of radiation dose.

关 键 词：对比增强能谱乳腺摄影 腺体厚度 辐射剂量 影响因素 

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