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目的通过调查全国15个省市不同级别医疗机构乳腺X射线摄影曝光参数并测量计算受检者乳腺平均剂量,分析我国乳腺X射线摄影中受检者压迫后乳房厚度分布及乳腺受照剂量水平,为建立适合我国成年女性受检者乳腺X射线摄影的剂量指导水平提供依据。方法按照《医用辐射危害评价与控制技术研究》实施方案的要求,调查临床实际乳腺摄影受检者的年龄、乳房压迫厚度、曝光参数、摄影体位等相关信息,通过手动曝光测量该条件下乳房压迫厚度处的入射空气比释动能(Ka,i),计算受检者的乳腺平均剂量(AGD)。结果共在全国15个省的149家医院调查了4372例乳腺X射线摄影体位,273台不同类型乳腺X射线摄影设备,包括屏片乳腺X射线摄影、计算机乳腺X射线摄影(乳腺CR)和直接数字乳腺X射线摄影(乳腺DR)设备,对于这三种类型的设备,头尾(CC)位投照时受检者AGD的平均值分别为1.21,1.77,1.61 m Gy,AGD的75%位分别为1.36,2.22,1.81 m Gy;斜侧(MLO)位时受检者AGD平均值分别为1.02,1.78,1.66 m Gy,AGD的75%位分别为1.23,2.46,1.81 m Gy。CC位和MLO位时乳房压迫厚度的中位数分别为4.2和4.5 cm。结论不同类型乳腺X射线摄影设备中,屏片乳腺X射线摄影设备致受检者的乳腺平均剂量最低,其次是乳腺DR设备,乳腺CR设备致患者剂量最高。
Objective To investigate the mammography exposure parameters of different levels of medical institutions in 15 provinces and cities in China and to measure and calculate the average breast dose of the subjects. To analyze the breast thickness distribution and the dose of mammary gland after the oppression of mammography in our country, To establish suitable for our adult female subjects mammography dosage guidance. Methods According to the requirements of the implementation plan of “Study on Evaluation and Control of Medical Radiation Hazard”, the author investigated the age, breast compression thickness, exposure parameters and photographic body position of clinical actual mammography and measured the breast pressure under the conditions by manual exposure Thickness of incident air kerma (Ka, i), calculate the average breast dose (AGD) of the subjects. Results A total of 4372 mammography positions and 273 different types of mammography equipment were surveyed in 149 hospitals in 15 provinces of China, including screen mammography, computed mammography (CR) and direct For these three types of equipment, the median AGD for the head-to-tail (CC) shot was 1.21, 1.77, 1.61 m Gy, and 75% of the AGD for digital mammography (1.36,2.22,1.81 m Gy, respectively). The mean AGD of the subjects at the MLO position was 1.02,1.78 and 1.66 m Gy, respectively, and the 75% of AGD were 1.23, 2.46 and 1.81 m Gy, respectively. Median breast compression thickness at CC and MLO were 4.2 and 4.5 cm, respectively. Conclusion Among the different types of mammographic radiographs, the average breast dose of the mammography equipment is the lowest, followed by the breast DR equipment and the highest dose of breast CR equipment.