对比增强能谱X线摄影乳腺病灶强化特点的定量分析

Quantitative Analysis of Enhancement Characteristics of Breast Lesions by Contrast Enhanced Energy Spectrum

目的定量分析对比增强能谱乳腺X线摄影(CESM)减影图像上乳腺病灶的强化特点,探索乳腺病灶的良恶性与其强化程度及强化类型的相关性。方法回顾性搜集因临床或超声检查怀疑乳腺病变而接受双侧乳房CESM检查的282例患者资料,分别测量CESM图像显示的病灶及乳腺本底在CC位、MLO位的信号值,并计算病灶的对比度噪声比和相对信号差,分析良恶性病灶的强化程度和强化类型的差异。结果恶性组的强化程度高于良性组(P<0.05),主要差异表现在浸润性癌组与良性病灶组之间;良性病灶多呈无强化(52.2%),强化的良性病灶强化类型多呈流入型,而恶性病灶大多出现强化(90.5%),其强化类型多呈流出型,差异有统计学意义(P<0.05)。结论乳腺病灶强化程度及强化类型的定量分析能为乳腺良恶性病灶的鉴别诊断提供依据,特别是浸润性癌与良性病灶的鉴别。

Objective To quantitatively analyze the enhancement characteristics of breast lesions on contrast⁃enhanced spectral mammography(CESM)subtraction images,and to explore the correlation between benign and malignant breast le⁃sions and the degree and patterns of enhancement.Methods The data of 282 patients who underwent bilateral breast CESM examination due to suspected breast lesions in clinical or ultrasonography from August 2017 to December 2021 in West China Hospital of Sichuan University were retrospectively collected.The signal values of the lesions shown on CESM images and the breast background at CC and MLO positions were measured respectively,and the contrast⁃to⁃noise ratio(CNR)and relative signal difference(RSD)of the lesions were calculated,and the differences in the enhancement degree and enhancement patterns of benign and malignant lesions were analyzed.Results The enhancement degree of the malig⁃nant group was higher than that of the benign group(P<0.05),and the main difference was between the invasive cancer group and the benign lesions group.the benign lesions were mostly non-enhanced(52.2%),and the enhancement pattern of the enhanced benign lesions is mostly ascending pattern.Most of the malignant lesions showed enhancement(90.5%),and most of the enhancement patterns were descending pattern,and the difference was statistically significant(P<0.05).Conclusion The quantitative analysis of enhancement degree and enhancement patterns of breast lesions can provide the basis for the differential diagnosis of benign and malignant breast lesions,especially the differentiation of invasive carcinoma and benign lesions.