【作者】 叶兆祥； 青春； 扬建梅； 赵玉梅；

【Author】 Ye zhao-Xiang Qing Chun Yang Jian-Mei Zhao Yu-Mei Department of diagnostic radiology, Tianjin Medical University Affiliated Cancer Hospital, Tianjin 300060, China

【机构】 天津医科大学附属肿瘤医院放射科；

【摘要】 目的:对传统的软片乳腺摄影和全数字乳腺摄影行临床影像评价并对两种成像方法进行比较。方法:选取接受传统软片乳腺摄影和全数字乳腺摄影患者的乳腺X线片各 100份分为软片组和数字组,每份病例均行患侧乳腺常规头尾位和内、外侧斜位的乳腺X线摄影。由3位有10年以上乳腺X线诊断经验的高年资医生对乳腺X线片进行独立临床影像评价。评价指标包括体位、压迫、伪影、曝光、对比度、清晰度、躁声、标记和总体评价等九项,评价等级分为有I优秀、Ⅱ良好、Ⅲ不及格三级,将3位医生的评价结果综合确定X线片等级,并对两种检查方法进行综合评价和比较。病例选取方法为随机抽取某个时间段内按时间顺序接受过乳腺摄影并在两周内行手术或活检的患者,软片乳腺摄影时间段选择为2003年3月,数字乳腺摄影时间段选择为2004年3月, 全部病例均经手术及病理证实。软片乳腺摄影采用美国 BENNETT公司CONTOURⅡ型乳腺机,数字乳腺摄影采用美国GE公司Senographe 2000D型乳腺机。结果:两组患者均为女性。软片组100例年龄19—72岁,平均48．6岁; 乳腺类型为I型5例,Ⅱ型13例,Ⅲ型20例,Ⅳ型62例, 良性病变30例,其中增生10例,炎症5例,纤维腺瘤10例, 囊肿、导管内乳头状瘤、脂肪瘤、导管分泌潴留、错构瘤各1 例,癌70例。数字组100例年龄19—76岁,平均50．9岁;乳腺类型为I型18例,Ⅱ型12例,Ⅲ型10例,Ⅳ型60例, 良性病变30例,其中增生9例,导管分泌潴留2例,乳头状瘤3例,纤维腺瘤12例,炎症、囊肿、脂肪坏死、脂肪瘤各 1例,癌70例。两组临床影像评价指标比较见表1,软片组 100例总体评价结果I、Ⅱ、Ⅲ级分别为68、30、2例,数字组100例总体评价结果I、Ⅱ,Ⅲ级分别为92、8、0例。两组患者影像诊断符合率分别为82％和92％,检出微小钙化的患者数分别为10例和23例。结论:两组临床影像评价指标中体位、压迫及标记3项无明显差异,伪影、曝光、对比度、清晰度、躁声和总体评价等6项有显著性差异,数字组I、Ⅱ级片率明显高于软片组。全数字乳腺摄影影像质量明显优于传统的软片乳腺摄影,影像诊断符合率和微小钙化的检出均比软片乳腺摄影有所提高。但限于病例数较小且非同一组患者同时接受两种检查比较,因此本结论有一定的局限性。更多还原

【Abstract】 100 women digital full-field mammographies (DM) (Senographe 2000D, GE) and 100 women conventional film-screen mammographies (FSM) (Contour II, Bennett)depicting histologically proven lesions were assessed by 3 readers independently. The clinical Image evaluation consist of an assessment of the 9 categories: positioning, compression, exposure, contrast, sharpness, noise, artifacts, labeling and overall impression. Image quality was rated by reader as grade I (excellent)/ II (good)/III(bad). The results of overall impression were 68/ 30/2 for FSM and 92/8/0 for DM. The diagnose accordance rate of two types were 82% for FSM and 92% for DM. The detection of microcalcifications were 10 cases for FSM and 23 cases for DM. No statistically significant differences were seen between the two types of mammography in assessing the positioning, compression, and labeling. The subjective assessment of exposure, contrast, sharpness, noise, artifacts, and labeling were found to be significantly better on digital mammographies. DM yielded a better performance compared to FSM for most of the parameters of the clinical Image evaluation.更多还原