低剂量乳腺X线摄影图像质量和辐射剂量的对比研究

摘要

Objective To investigate the value of the low-dose mode of molybdenum-rhodium target X-ray photography in mammary examination.Methods Two hundred female clients were recruited,and their bilateral mammographic images were prospectively acquired by the standard mode(STD) and dose mode(DOSE) in both cranial and caudal(CC) position and mediolateral oblique(MLO) position using molybdenum-rhodium target X-ray machine.The total of 800 mammograms were obtained and analyzed to assess the image quality with double-blind method.The value of average glandular dose(AGD) and entrance skin exposure(ESE) on each client were detected and recorded respectively.The contrast analysis between STD and DOSE on display rate of calcification,positive rate of lesion and detection rate of breast cancer were performed.Results The mammary gland and characteristics of lesion were clearly displayed in both STD and DOSE images.Compared with the STD,the reduction of X-ray exposure such as AGD and ESE values detected by DOSE was 17.21% and 12.78% respectively, there was a significant difference in AGD and ESE values between the two modes.FAGD = 44.070,P = 0.000, FESE=14.896,P= 0.000.The display rate of calcification was 46% in DOSE and 57% in STD.The positive rate of lesion was 14% and 22% in DOSE and STD respectively,there was no significant difference in the positive rate of lesion between DOSE and STD,x2= 0.153,P = 0.086.The detection rate of breast cancer was 6% and 7% in two modes respectively,The ANOVA results showed that the differences of the detection rate of breast cancer between STD and DOSE was no significant,x2= 0.752,P = 0.605.Conclusions Under the condition of achieving equivalent quality of mammograms,the dose mode may effectively decrease radiation exposure on client in molybdenum- rhodium target mammography.%目的：探讨低剂量摄影模式在乳腺X线检查中的价值。方法利用钼铑双靶乳腺X线机，采用标准模式（standard model,STD）和剂量优先模式（dose model,DOSE）对200例女性受检者双侧乳腺进行头尾位（cranial and caudal,CC）和内外斜位（mediolateral oblique,MLO）摄影，双盲法评价800幅乳腺图像质量，分别记录每名受检者乳腺平均腺体剂量值（average glandular dose,AGD）和皮肤入射剂量值（entrance skin exposure,ESE），对两种摄影模式的钙化显示率、病变阳性率和乳腺癌检出率进行对比分析。结果两种模式下乳腺图像均能够清晰显示正常腺体和病变结构；与STD模式相比，DOSE模式下受检者乳腺AGD降低17.21%，ESE降低12.78%，两者间均具有显著性差异，FAGD=44.070,P=0.000，FESE =14.896，P=0.000。DOSE模式下钙化显示率为46%，STD模式下钙化显示率为57%；两种模式下病变阳性率分别为14%和22%，两者间无显著性差异，x2=0.153，P=0.086；两种模式乳腺癌检出率分别为6%和7%，两者间无显著性差异，x2=0.752，P=0.605。结论在获取同等乳腺图像质量情况下,钼铑双靶乳腺X线检查中DOSE模式能够有效降低受检者的辐射剂量。