乳腺癌筛查中乳腺X射线摄影两种标准体位及乳腺压迫厚度与平均腺体剂量的关系

辐射防护 ›› 2022, Vol. 42 ›› Issue (5): 495-500.

乳腺癌筛查中乳腺X射线摄影两种标准体位及乳腺压迫厚度与平均腺体剂量的关系

李玲玲¹, 钱银锋², 王弢¹, 李丽¹

1.六安市中医院放射科,安徽六安 237000;
2.安徽医科大学第一附属医院放射科,合肥 230022

收稿日期:2022-03-10 出版日期:2022-09-20 发布日期:2022-10-17
通讯作者: 钱银锋。E-mail:894206876@qq.com
作者简介:李玲玲(1987—),女,2010年7月毕业于蚌埠医学院医学影像学系,2019年6月获安徽医科大学影像医学与核医学硕士学位,主治医师。E-mail:332136808@qq.com

Relationship between two standard positions of mammography and breast compression thickness and average glandular dose in breast cancer screening

LI Lingling¹, QIAN Yinfeng², WANG Tao¹, LI Li¹

1. Department of Ultrasound, Lu'an Hospital of Traditional Chinese Medicine, Anhui Lu'an 237000;
2. Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022

Received:2022-03-10 Online:2022-09-20 Published:2022-10-17

摘要/Abstract

摘要： 为了使乳腺X射线摄影在乳腺癌筛查中的应用达到最优化,本文回顾性分析了在我院行乳腺X射线摄影和乳腺彩色多普勒超声检查,并取得病理结果的患者共132人、139个病灶,比较乳腺头尾位(craniocaudal view,CC)、内外侧斜位(medial lateral oblique view,MLO)、乳腺压迫厚度、乳腺密度与被检者接受的平均腺体剂量(average glandular dose,AGD)的关系及两种体位上病灶检出情况。结果显示:(1)乳腺压迫厚度及乳腺密度都是AGD的独立影响因素,并呈正相关,且乳腺压迫厚度对AGD的影响比乳腺密度大;(2)曝光参数管电压及管电流随着乳腺压迫厚度的增加有增加趋势,致使AGD增大;(3)同一乳腺CC及MLO的压迫厚度及AGD未发现特定规律,但均数±标准差CC位(2.49±0.84)＞MLO位(2.27±0.81),且MLO比CC更易显示病灶。只拍摄乳腺MLO联合乳腺彩色多普勒超声检查具有很大优势,不仅保证了诊断需要,更降低了被检者的AGD值,且被检者乳腺压迫厚度及乳腺密度越大,AGD降低越多。

关键词: 乳腺X射线摄影, 平均腺体剂量, 乳腺压迫厚度, 乳腺癌筛查

Abstract: In order to optimize the application of mammography in breast cancer screening, we retrospectively analyzed 132 patients with 139 lesions who underwent mammography and breast color doppler ultrasonography in our hospital, and obtained pathological results(CC), medial lateral oblique view (MLO), breast compression thickness, breast density and the average glandular dose (AGD) received by the subjects, and the detection of lesions in two positions.The results showed that: (1) Both breast compression thickness and breast density were independent influencing factors of AGD, and were positively correlated; and the influence of breast compression thickness on AGD was greater than that of breast density. (2) The exposure parameters tube voltage and tube current tended to increase with the increase of breast compression thickness, resulting in the increase of AGD. (3) No specific pattern was found in the compression thickness and AGD of CC and MLO in the same breast, but the mean ± standard deviation at CC position was (2.49±0.84) which is greater than that of MLO position (2.27±0.81), and MLO was more prone to display lesions than CC. MLO combined with breast color Doppler ultrasound examination has great advantages, which not only ensures the need for diagnosis, but also reduces the AGD value of the subject. Moreover, the greater the thickness of breast compression and the density of the subject, the more the AGD decreases.

Key words: mammography, average glandular dose, breast compression thickness, breast cancer screening

中图分类号:

R144.1

李玲玲, 钱银锋, 王弢, 李丽. 乳腺癌筛查中乳腺X射线摄影两种标准体位及乳腺压迫厚度与平均腺体剂量的关系[J]. 辐射防护, 2022, 42(5): 495-500.

LI Lingling, QIAN Yinfeng, WANG Tao, LI Li. Relationship between two standard positions of mammography and breast compression thickness and average glandular dose in breast cancer screening[J]. RADIATION PROTECTION, 2022, 42(5): 495-500.

参考文献

[1] 周广敏,谢铁明.数字乳腺X线摄影平均腺体计量与曝光参数及乳腺压迫厚度的关系[J].医疗装备,2020,33(21):1-4.
ZHOU Guangmin, XIE Tieming.Relationship between mean glandular measurement and exposure parameters and breast compression thickness in digital mammography[J].Medical Equipment,2020,33(21):1-4.
[2] Hamdi Y,Boujemaa M,Rekaya M B,et al.Family specific genetic predisposition to breast cancer: results from Tunisian whole exome sequenced breast cancer cases[J].Journal of Translational Medicine, 2018,16(1):158.
[3] Mitra S E,Taleghani Fariba,Tabatabaeian Maryam,et al.A qualitative exploration of personality factors in breast cancer screening behavior[J].Social Behavior & Personality An International Journal,2018,46(1):91-97.
[4] Jalilvand M,Oloomi M,Reza Najafipour.An association study between CHEK2 gene mutations and susceptibility to breast cancer[J].Comparative Clinical Pathology,2017,26(4):837-845.
[5] 张娜,刘朝兴.石家庄市乳腺癌的筛查结果分析[J].当代医学,2021,27(19):102-105.
ZHANG Na, LIU Chaoxing.Analysis of breast cancer screening results in Shijiazhuang City[J].Contemporary Medical,2021,27(19):102-105.
[6] 黄勇,王丹丹.乳腺X线摄影射线剂量对乳腺X线片质量的影响[J].临床放射学杂志,2012,31(2):188-191.
HUANG Yong, WANG Dandan.Effect of radiation dose on mammography quality[J].Journal of Clinical Radiology,2012,31(2):188-191.
[7] 罗珺,李彬,倪慧霞,等.数字乳腺X线摄影平均腺体剂量与乳腺分型及压迫厚度的关系[J].昆明医科大学学报,2017,38(3):79-82.
LUO Jun, LI Bin, NI Huixia, et al.Relationship between mean glandular dose and breast classification and compression thickness on digital mammography[J].Journal of Kunming Medical University,2017,38(3):79-82.
[8] 王晓娜,苏丹华,王心韬,等.福州地区乳腺数字 X 射线摄影辐射剂量调查[J].河南预防医学杂志,2021,32(3):228-230.
WANG Xiaona, SU Danhua, Wang Xintao, et al.Radiation dose survey of breast digital radiography in Fuzhou area[J].Henan Journal of Preventive Medicine,2021,32(3):228-230.
[9] 杜莉娟.彩色多普勒超声联合乳腺钼靶检查在早期乳腺癌筛查中的应用价值[J].实用医技杂志,2021,28(6):770-772.
DU Lijuan.Application value of color Doppler ultrasound combined with mammography in early breast cancer screening[J].Journal of Practical Medical Technology,2021,28(6):770-772.
[10] 张琳,聂惠龙.X射线钼靶和高频超声在早期乳腺癌中的诊断价值[J].中国妇幼保健,2016,31(5):1077-1078.
ZHANG Lin, NIE Huilong.Diagnostic value of X-ray molybdenum target and high frequency ultrasound in early breast cancer[J].Maternal and Child Health in China,2016,31(5):1077-1078.

[1]	肖杨, 黄顺平, 李恒, 吴艳, 李进, 刘宏, 陈晓琳. 肺密度变化对组织吸收剂量影响的模拟研究[J]. 辐射防护, 2022, 42(4): 354-360.
[2]	陈倩兰, 骆志平, 刘森林. 基于ICRP 141号报告模型计算吸入²⁴¹Am后的排泄份额及剂量的对比分析[J]. 辐射防护, 2021, 41(3): 193-200.
[3]	陈倩兰, 骆志平, 刘森林. 基于ICRP 141号报告的²⁴¹Am吸入后滞留份额计算及新旧模型异同[J]. 辐射防护, 2021, 41(1): 17-26.
[4]	王亮, 彭勇, 刘怡, 彭红芬. 医院级CT辐射剂量及诊断剂量水平研究[J]. 辐射防护, 2019, 39(6): 517-521.
[5]	王亮, 彭勇, 刘怡, 彭红芬. 医院级CT辐射剂量及诊断剂量水平研究[J]. 辐射防护, 2019, 39(6): 517-521.
[6]	杨素云, 胡婷婷, 王宏力, 师晓丽, 刘丽娜, 唐国华, 池翠萍. 甲状腺癌病人行¹³¹I治疗急症处理中个人受照剂量的评估[J]. 辐射防护, 2019, 39(3): 228-233.
[7]	李阳, 李建国, 王艾俊. 基于面元模型的河蚌剂量转换系数的计算[J]. 辐射防护, 2017, 37(6): 465-471.
[8]	唐邵华, 吕炜枫, 刘杰, 熊军, 黄倩倩. 核电站三维剂量场评价系统的开发及应用[J]. 辐射防护, 2017, 37(5): 347-354.
[9]	侯杰, 李航, 沈福, 陈晓秋. 秦山核电厂气态流出物气溶胶粒径分布测量[J]. 辐射防护, 2017, 37(4): 249-253.
[10]	陶乃贵, 刘占阳, 陶云良. 核电厂正常运行放射性流出物对婴儿的食入剂量研究[J]. 辐射防护, 2017, 37(4): 274-279.
[11]	李华, 赵原, 刘立业, 肖运实, 李君利. 基于MCNP对γ射线吸收剂量累积因子的计算与研究[J]. 辐射防护, 2017, 37(3): 161-168.
[12]	曹磊, 邓君, 兰长林, 宋延超, 丁晓文, 马驰, 郭泽钦, 郑昀, 邱羽桐. 基于CR39固体核径迹探测器的低能中子剂量测量方法初步研究[J]. 辐射防护, 2017, 37(3): 174-179.
[13]	高飞, 肖雪夫, 倪宁, 侯金兵, 宋明哲. 可作为校准检定用标准剂量计的能量补偿型高气压电离室改进[J]. 辐射防护, 2017, 37(2): 87-93.
[14]	刘潇, 曾勇明, 郁仁强, 王杰, 孙静坤. 基于蒙特卡罗数学模型评价不同螺距冠状动脉CCTA受检者辐射剂量的特点与验证[J]. 辐射防护, 2017, 37(2): 131-137.
[15]	梁保辉, 陈志, 徐榭. CT检查个体化辐射剂量估算研究现状[J]. 辐射防护, 2017, 37(2): 153-160.