【摘要】 目的 定量评估对比增强能谱乳腺摄影（CESM）的辐射剂量水平。方法 回顾性分析2020年3月至2022年7月于本院放射科一个月内先后完成CESM、数字乳腺断层合成摄影（DBT）两项检查的183例患者影像资料。分析不同体位CESM高低能摄影的平均腺体剂量（AGD）分布情况及与腺体厚度的关系。并将CESM的AGD_总与DBT的AGD、欧洲诊断参考水平（包括可接受水平、可达到水平）比较。结果 CESM双侧头尾位（CC）、内外侧斜位（MLO）的中位AGD_总分别为1.89 mGy（1.74 mGy, 2.31 mGy）、2.04 mGy（1.77 mGy, 2.62 mGy）,CC位AGD_总低于MLO位（Z=-6.02,P<0.05）。AGD_低能占AGD_总的74%～83%,AGD_高能占AGD_总的17%～26%。腺体厚度与AGD_低能、AGD_高能、AGD_总呈中度相关或强相关，相关系数（r_s）（CC/MLO）分别为0.602/0.758、0.841/0.857、0.763/0.832。CESM AGD_总比DBT AGD高30%左右，差异有统计学意义（CC位：Z=-14.61,P<0.05;MLO位：Z=-14.78,P<0.05）。CESM AGD_总在各腺体厚度范围内，大多高于可达到水平。当腺体厚度≥30 mm时，CESM AGD_总均在可接受水平以下；当腺体厚度<30 mm时，AGD_总略高于可接受水平。结论 CESM辐射剂量高于DBT,与腺体厚度呈正相关。在各腺体厚度范围内，CESM辐射剂量在诊断参考水平范围内。更多还原

【Abstract】 Objective To evaluate the radiation dose of contrast-enhanced spectral mammography(CESM). Methods 183 patients who were completed the CESM and digital breast tomosynthesis(DBT) examination in our hospital from March 2020 to July 2022.Analyzed the average glandular dose(AGD) of CESM and the correlation of AGD with compressed breast thickness in different examination positions.Compared the total-AGD of CESM with the AGD of DBT and European diagnostic reference level(including acceptable level and achievable level). Results The median total-AGD of CESM in cranio-caudal(CC) and medial lateral oblique(MLO) were 1.89 mGy(1.74 mGy, 2.31 mGy),2.04 mGy(1.77 mGy, 2.62 mGy).The AGD of CC was lower than that of MLO(Z=-6.02,P<0.05).The AGD of low energy(LE-AGD) of CESM accounts for 74%-83% of the total-AGD,and the AGD of high energy(HE-AGD) of CESM accounts for 17%-26% of the total-AGD.The compressed breast thickness was moderately or strongly correlated with LE-AGD,HE-AGD and total-AGD,and the correlation coefficients(CC/MLO) were 0.602/0.758,0.841/0.857,0.763/0.832,respectively.The total-AGD of CESM was higher(about 30%) than that of DBT(CC:Z=-14.61,P<0.05;MLO:Z=-14.78,P<0.05).CESM total-AGD was higher than that of the achievable level.When the compressed breast thickness was above or equal to 30mm, CESM total-AGD was always lower than that of the acceptable level; When the compressed breast thickness was less than 30 mm, CESM total-AGD was slightly higher than that of the acceptable level. Conclusion The radiation dose of CESM is higher than that of DBT,which is positively correlated with the compressed breast thickness.Within the range of each compressed breast thickness, the radiation dose of CESM is within the diagnostic reference level.更多还原