【摘要】 目的 对比通用医疗（GE HealthCare,GE）两代乳腺X线机（Senographe Essential 2019款与Senographe Pristina Hygeia 2023款）在对比增强乳腺摄影（CEM）中双轮廓伪影的发生情况，分析新机型的伪影控制效果及技术改进优势，为临床CEM设备优化应用与图像质量控制管理提供依据。方法 回顾性搜集行CEM检查的女性患者影像学资料，按检查设备分为旧机组（Senographe Essential）与新机组（Senographe Pristina Hygeia）两组，每组各200例患者资料，每例均行标准头尾位（CC）、内外斜位（MLO）CEM检查，每组各获取800幅减影图像，总计1600幅图像纳入研究。采用4级双轮廓伪影分级标准，由两名高年资乳腺放射医师双盲法独立阅片评价，采用Kappa检验分析观察者间一致性；组间伪影发生率比较采用Pearson卡方检验，分析设备及技术的改进对伪影控制的影响。结果 两组患者基线资料均衡可比（均P>0.05）；两名医师阅片一致性良好（Kappa=0.83,P<0.001）。新机组双轮廓伪影总发生率为9.50%，显著低于旧机组的61.25%（χ~2=468.58,P<0.001）；新机组中重度伪影发生率为3.12%，显著低于旧机组的55.37%（χ~2=527.692,P<0.001）。结论 GE新一代乳腺X线机通过快速高低能曝光切换、智能靶/滤过匹配、高灵敏度探测器、高滤线栅栅比及优化减影算法等硬件技术的改进与软件的升级，可显著降低CEM双轮廓伪影的发生率与严重程度，提升图像稳定性与诊断可靠性，具有重要的临床应用价值。更多还原

【Abstract】 Objective To compare the occurrence of double-contour artifacts in contrast-enhanced mammography(CEM) between two generations of GE Mammography machine(Senographe Essential 2019 and Senographe Pristina Hygeia 2023),analyze the artifact control effectiveness and technical advantages of the new model,and provide a basis for optimizing clinical CEM equipment application and image quality management. Methods Imaging data of female patients who underwent CEM at a single institution were retrospectively reviewed.Patients were allocated into two groups according to the equipment used:the older system group(Senographe Essential) and the newer system group(Senographe Pristina Hygeia),with 200 patients in each group.All patients underwent standard CEM in craniocaudal(CC) and mediolateral oblique(MLO) projections.A total of 800 subtracted images were acquired per group,and 1600 images in total were included in the analysis.A 4-point grading scale for double-contour artifacts was applied.Two experienced breast radiologists independently interpreted images in a double-blind fashion.Interobserver agreement was assessed using the Kappa test.Differences in artifact incidence between groups were analyzed using Pearson χ~2 test to evaluate the effect of hardware and technical upgrades on artifact reduction. Results The baseline data of the two groups were balanced and comparable(all P>0.05).The interobserver agreement between the two radiologists was good(Kappa=0.83,P<0.001).The total incidence of double-contour artifacts in the new group was 9.50%,significantly lower than that in the old group(61.25%)（χ~2=468.58,P<0.001）.The incidence of moderate-to-severe artifacts in the new group was 3.12%,significantly lower than that in the old group(55.37%)（χ~2=527.692,P<0.001）. Conclusion The new generation of GE Mammography machine significantly reduces the incidence and severity of CEM double-contour artifacts through Hardware and software technological improvements, such as rapid high-low energy exposure switching,intelligent target/filter matching,high-sensitivity detectors,high grid ratio,and an optimized subtraction algorithms,enhancing image stability and diagnostic reliability,with important clinical application value.更多还原