Correlation between mean gland dose and breast lesions in contrast-enhanced spectral mammography
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摘要:
目的探讨乳腺病变类型、病变良恶性及病变大小对对比增强乳腺X线摄影（CESM）低能图、高能图及减影后图像的乳腺平均腺体剂量（AGD）的影响。 方法收集2018年2~10月于本院行CESM检查且经过组织学病理学证实的123例女性患者作为研究对象。根据病变良恶性、主要病变类型（非肿块型与肿块型）及肿块型病变大小进行分组，比较不同组患者的低能图AGD、高能图AGD及减影后图像的AGD（减影后图像的AGD为低能图加高能图像AGD的总和）。 结果恶性病变65例，良性病变58例; 肿块型病变86例，非肿块型病变37例。肿块≥2 cm 44例， < 2 cm 42例; 恶性肿块≥2 cm 32例， < 2 cm 25例。恶性病变组无论低能、高能以及减影后的AGD均高于良性病变组，差异具有统计学意义（P < 0.05）; 无论良恶性病变，乳腺患侧高能AGD均高于健侧，差异均具有统计学意义（P < 0.05）。肿块型病变组低能、高能及减影后的AGD差异均无统计学意义（P>0.05）。肿块长径≥2 cm组高能、低能及减影后的AGD均高于肿块长径 < 2 cm组，差异有统计学意义（P < 0.05）; 其中，恶性肿块长径≥2 cm组的高能图AGD较肿块长径 < 2 cm组高，差异具有统计学意义（P < 0.05）。 结论恶性病变、≥2 cm肿块AGD高于良性病变及 < 2 cm肿块; 无论病变良恶性，患侧高能AGD均高于健侧。 -
关键词:
- 对比增强乳腺X线摄影 /
- 良恶性 /
- 肿块大小 /
- 平均腺体剂量
Abstract:ObjectiveTo investigate the effect of breast lesion type, benign or malignant lesion and lesion size on the average glandular dose (AGD) in low-energy, high-energy and subtraction images of contrast-enhanced mammography. MethodsA total of 123 female patients who underwent CESM examination in our hospital from February 2018 to October 2018 and confirmed by histopathology were enrolled as subjects. According to benign and malignant lesions, major lesion types, and mass lesion size, patients were divided and the total AGD of low energy imaging, high energy imaging and subtracted imaging (the subtraction imaging AGD is the sum of low energy imaging and high energy imaging) were compared in different groups. ResultsThere were 65 cases of malignant lesions and 58 cases of benign lesions. There were 86 cases of mass lesions and 37 cases of non-mass lesions. The tumor size was ≥2 cm in 44 cases, < 2 cm in 42 cases, including malignant mass ≥ 2 cm in 32 cases and < 2 cm in 25 cases. The AGD of the malignant lesion group was higher than the benign lesion group regardless of low energy, high energy and subtraction, and the results were statistically significant (P < 0.05). Both benign and malignant lesions were higher on the affected side than on the healthy side, and the results were statistically significant (P < 0.05). The AGD of the low energy, high energy and subtraction in the mass lesion group were higher than those in the nontumor lesion group, but the results were not statistically significant (P>0.05). The AGD of high energy, low energy and subtraction in the group with a long diameter ≥2 cm was higher than that in a group with a long diameter < 2 cm, and the results were statistically significant (P < 0.05). The AGD was higher than the group with a diameter < 2 cm, and the results were statistically significant (P < 0.05). ConclusionThe AGD of malignant lesions and ≥2 cm masses were higher than that of benign lesions and < 2 cm masses. The high energy AGD of the affected side was higher than that of the healthy side, no matter whether the lesions were benign or malignant. -
表 1 良恶性病变低能图、高能图及减影后图像的AGD
Table 1. AGD of low energy, high energy and subtraction images of benign and malignant lesions (mGy)
AGD/病变性质 平均值 方差 范围 F P 低能图AGD 11.25 0.001 恶性病变 6.10 1.62 3.46~10.88 良性病变 5.20 1.20 3.27~10.03 高能图AGD 5.73 0.018 恶性病变 2.06 0.79 0.96~3.83 良性病变 1.74 0.67 0.99~3.59 减影后AGD 9.73 0.002 恶性病变 8.17 2.35 4.46~14.71 良性病变 7.45 1.81 4.27~13.26 AGD: 乳腺平均腺体质量. 
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表 2 乳腺良、恶性病变健侧与患侧低能图、高能图及减影后图像的AGD
Table 2. AGD of low energy, high energy and subtraction image of healthy and affected sides of benign and malignant breast lesions (mGy)
病变性质/病变部位 平均值 方差 95%CI t P 恶性病变 低能图AGD患侧-健侧 -0.006 0.54 -0.14~0.12 -0.08 0.929 高能图AGD患侧-健侧 0.11 0.28 0.04~0.18 3.17 0.002 减影后AGD患侧-健侧 0.10 0.77 -0.08~0.29 1.12 0.266 良性病变 低能图AGD患侧-健侧 0.02 0.43 -0.08~0.13 0.42 0.670 高能图AGD患侧-健侧 0.06 0.21 0.01~0.12 2.38 0.020 减影后AGD患侧-健侧 0.09 0.60 -0.06~0.25 1.15 0.251
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表 3 乳腺肿块型病变与非肿块型病变的AGD对比
Table 3. Comparison ofAGD between breast mass lesions and non-mass lesions (mGy)
AGD/病变类型 平均值 方差 范围 F P 低能图AGD 1.55 0.215 肿块型病变 5.75 1.57 3.27~10.88 非肿块型病变 5.40 1.03 3.39~7.96 高能图AGD 1.57 0.212 肿块型病变 1.95 0.80 0.96~3.83 非肿块型病变 1.77 0.56 1.00~3.10 减影后AGD 1.66 0.200 肿块型病变 7.71 2.32 4.27~14.71 非肿块型病变 7.18 1.48 4.41~10.52
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表 4 乳腺肿块型病变长径≥2 cm组与长径 < 2 cm组的AGD对比
Table 4. Comparison of AGD between long diameter ≥2 cm group and long diameter < 2 cm group of breast mass lesions (mGy)
AGD/病变长径 平均值 方差 范围 F P 低能图AGD ≥2 cm组 6.20 1.76 3.31~10.88 7.53 0.007 < 2 cm组 5.30 1.21 3.27~8.63 高能图AGD ≥2 cm组 2.20 0.88 0.96~3.83 11.08 0.001 < 2 cm组 1.66 0.59 0.99~3.25 减影后AGD ≥2 cm组 8.41 2.58 4.31~14.71 9.05 0.003 < 2 cm组 6.96 1.77 4.27~11.88
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表 5 乳腺恶性肿块型病变长径≥2 cm组与长径 < 2 cm组的AGD对比
Table 5. Comparison of AGD between long diameter ≥2 cm group and long diameter < 2 cm group of breast malignant mass lesions (mGy)
AGD/病变长径 平均值 方差 范围 F P 低能图AGD ≥2 cm组 6.39 1.84 3.63~10.88 1.89 0.174 < 2 cm组 5.78 1.29 3.46~8.63 高能图AGD ≥2 cm组 2.28 0.86 0.96~3.83 4.34 0.042 < 2 cm组 1.84 0.65 1.00~3.25 减影后AGD ≥2 cm组 8.67 2.64 4.63~14.71 2.70 0.106 < 2 cm组 7.63 1.90 4.46~11.88
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