对比DBT三种自动曝光模式在致密型乳腺中的临床应用价值

Comparison of Clinical Application Value of Three Automatic Exposure Modes of Digital Breast Tomosynthesis in Dense Breast

目的探讨数字乳腺三维断层融合(Digital Breast Tomosynthesis,DBT)摄影中辐射剂量优先模式(Dose Priority Mode,DOSE)、标准模式(Standard Mode,STD)、对比度优先模式(Contrast Priority Mode,CNT)三种自动曝光模式在致密型乳腺诊断中的临床应用价值。方法回顾性分析2016年3月至2019年11月来我院行DBT双乳正斜位摄影的致密型乳腺患者,从中抽取DOSE、STD、CNT三种曝光模式各70例,并根据腺体厚度的不同分别分成≤30 mm、31~45 mm、46~60 mm、>60 mm四组。比较相同乳腺厚度区间时,三种曝光模式的图像质量和辐射剂量差异。结果相同乳腺厚度区间时,三种曝光模式的图像质量没有显著性差异(P>0.05)。当乳腺厚度在≤30 mm和31~45 mm区间时,平均腺体剂量差异有统计学意义(P<0.001),其中DOSE最低;当乳腺厚度在46~60 mm时,DOSE与STD差异无统计学意义(P>0.05),而与CNT比较,差异有统计学意义(P<0.001);当乳腺厚度>60 mm时,三种曝光模式下的平均腺体剂量比较,差异均没有统计学意义(P>0.05)。结论在致密型乳腺DBT摄影中,在保证成像质量的前提下根据腺体厚度选择最优化的曝光模式可有效减少患者摄影时的辐射剂量。

Objective To explore the clinical application value of three automatic exposure modes of dose priority mode(DOSE),standard mode(STD)and contrast priority mode(CNT)of three-dimensional digital breast tomosynthesis(DBT)in the diagnosis of dense breast.Methods From March 2016 to November 2019,the dense breast patients who underwent DBT positive and oblique position photography in our hospital were retrospectively analyzed,and the 70 cases in each of the three exposure modes were selected.According to the different thickness of gland,they were divided into four groups including≤30 mm,31-45 mm,46-60 mm and>60 mm.The image quality and radiation dose of the three exposure modes were compared in the same breast thickness range.Results There was no significant difference in image quality between the three exposure modes at the same breast thickness interval(P>0.05).When the breast thickness of mammary gland was≤30 mm and 31-45 mm,there were significant differences in the average gland dose(AGD)(P<0.001),among which DOSE mode was the lowest.When the breast thickness was 46-60 mm,there was no significant difference between DOES and STD(P=0.75),but there was significant difference between DOSE and CNT(P<0.001).When the thickness of breast was>60 mm,there was no significant difference in the AGD under the three exposure modes(P>0.05).Conclusion In the dense breast DBT photography,under the premise of ensuring the imaging quality,selecting the optimal exposure mode according to the gland thickness can effectively reduce the radiation dose of patients.