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目的探讨双侧双能量(DE)对比剂增强(CE)数字乳腺钼靶摄影的可行性,并与传统数字乳腺钼靶摄影及MR成像对比,从而评估其在女性乳腺癌病人中的应用价值。材料与方法本研究经过伦理委员会批准,符合HIPAA并获得了书面知情同意书。病人纳入时间为2010年3月—2011年8月,病人年龄25～74岁,平均49.6岁。10例新近诊断为乳腺癌的女性按每千克体质量静脉注射1.5mL碘海醇,并在注射后2.5～10min内采集图像以评估可行性。当可行性得到证实后,52例近期经乳腺MR检查诊断为乳腺癌的女性病人将接受DECE数字乳腺钼靶摄影检查。阳性结果与病理结果对照。结果可行性被证实,并且无不良反应。对比剂注射后可见肿瘤强化时间长达10min,肿瘤的强化与时间无关。MR成像与DECE数字乳腺钼靶摄影均在52例肿瘤中检测出50例(96%);传统数字乳腺钼靶摄影检测出42例(81%)。使用DECE数字乳腺钼靶摄影检出病灶大小为4～67mm(中间值17mm)。DECE数字乳腺钼靶摄影在25个同侧额外肿瘤病灶中检测出14个(56%),MRI检测出22个(88%)。在DECE数字乳腺钼靶摄影中有2例假阳性结果,而MR成像中出现13例假阳性结果。有1例对侧癌灶在各项检查中均未显示。结论双侧DECE数字乳腺钼靶摄影可行且容易实施。它对于已知原发肿瘤的检出率与MR成像相当,高于传统数字乳腺钼靶摄影。DECE数字乳腺钼靶摄影对于额外的同侧肿瘤病灶检出敏感性较MR成像低,但特异性更高。
Objective To investigate the feasibility of bilateral dual-energy contrast-enhanced (CE) digital mammography and evaluate the value of mammography in comparison with traditional digital mammography and MR imaging. Materials and Methods The study was approved by Ethics Committee, in accordance with HIPAA and obtained written informed consent. Patients were included in the time from March 2010 to August 2011, the patient aged 25 to 74 years, mean 49.6 years old. Ten women newly diagnosed with breast cancer were intravenously injected with 1.5 mL of iohexol per kilogram of body weight and images were taken within 2.5-10 min after injection to assess viability. When feasibility has been confirmed, 52 patients with recent breast MR diagnosed breast cancer will undergo DECE digital mammography. Positive results and pathological results. The feasibility of the results was confirmed, and no adverse reactions. Contrast agent can be seen after tumor strengthening for up to 10min, the enhancement of the tumor has nothing to do with time. MR imaging and DECE digital mammography were detected in 52 cases (50%) of tumors (96%); 42 cases (81%) were detected by conventional digital mammography. The lesion size was 4 to 67 mm (median 17 mm) using the DECE Digital Mammography. DECE digital mammography detected 14 (56%) in 25 ipsilateral extra tumor lesions and 22 (88%) were detected by MRI. There were 2 false positives in DECE digital mammography and 13 false positives in MR imaging. A case of contralateral foci in the examination were not shown. Conclusions Bilateral DECE digital mammography is feasible and easy to implement. Its detection rate of known primary tumors is comparable to that of MR imaging and higher than that of traditional digital mammography. The DECE digital breast mammography is less sensitive than MR imaging for detection of additional ipsilateral tumor lesions but is more specific.