摘要
目的:通过对临床可触及肿块的乳腺肿瘤患者健侧及患侧乳腺的平均腺体剂量(average gland dose,AGD)进行分析,分析乳腺肿块、密度与辐射剂量之间的相关性。方法:收集2019年1—12月于复旦大学附属肿瘤医院就诊的临床可触及乳腺肿块的患者204例,对患者行双侧乳腺头尾(craniocaudal,CC)位及内外斜(mediolateral oblique,MLO)位标准摄影检查,统计乳腺密度、压迫厚度、不同年龄段的辐射剂量,探讨乳腺X线摄影中乳腺肿块、密度与辐射剂量之间是否存在相关性。结果:在204例患者中,右侧乳腺有肿块的患者101例,左侧乳腺有肿块的患者103例。根据腺体类型进行分类,脂肪型(a型)5例,散在纤维腺体型(b型)52例,不均匀致密型(c型)132例,极度致密型(d型)15例;根据年龄进行分类,40岁以下的患者30例,41~50岁的患者65例,51~60岁的患者52例,61~70岁的患者40例,71岁以上的患者17例。比较乳腺肿块患者的健侧及患侧乳腺的AGD时,患侧乳腺的AGD较健侧乳腺的AGD高30.66%,差异有统计学意义(P<0.05)。不同乳腺腺体类型的健侧和患侧曝光剂量组内差异均有统计学意义(P<0.05);对健侧和患侧的曝光剂量组间比较时,a、b、c和d型腺体类型的AGD分别增加了48.34%、26.80%、28.64%和60.71%,可见d型腺体的AGD增幅最大,b型腺体的AGD增幅最少(P<0.05)。各年龄段中健侧和患侧的AGD值组内、组间差异均有统计学意义(P<0.05),其中年龄大于70岁患者的AGD增幅最大,41~50岁患者的AGD增幅最少,差异有统计学意义(P<0.05)。结论:乳腺X线摄影中,患侧乳腺的辐射剂量不仅与乳腺密度、压迫厚度相关,也与乳腺有无肿块有关。而且,患侧乳腺的AGD高于健侧,不同年龄段之间的辐射剂量也存在差异。
Objective:To compare the average gland dose(AGD)of unaffected breast with affected breast of clinically palpable breast tumors patients,and anlyze the correlation between breast lumps,density and radiation dose.Methods:A total of 204 clinically palpable breast tumors patients in Fudan University Shanghai Cancer Center from January 2019 to December 2019were collected,and were performed standard photographic examinations on the craniocaudal(CC)and mediolateral oblique(MLO)positions of bilateral breasts.Breast density,compression thickness,and radiation dose of different ages were counted to explore whether there is a correlation between breast lump and radiation dose in mammography.Results:A total of 204 patients,including 101 patients with right breast lumps and 103 patients with left breast lumps.According to the classification of gland types,there were 5 cases of fat type(type a),52 cases of scattered fibroglandular type(type b),132 cases of uneven dense type(type c),and 15 cases of extremely dense type(type d);according to age classification,30 patients were under 40 years old,65 patients were 41-50 years old,52 patients were 51-60 years old,40 patients were 61-70 years old,and 17 patients were over 71 years old.When we compared the AGD of the unaffected and affected breasts of patients with breast lumps of various gland types and different ages,the AGD of the affected breast was 30.66%higher than that of the unaffected breast,and there was a statistical difference(P<0.05).There were statistically significant differences in the exposure dose groups of the unaffected side and the affected side of the different breast gland types(P<0.05);when we compared the exposure dose groups between the unaffected side and the affected side,the AGD of type a,b,c,and d increased by 48.34%,26.80%,28.64%and 60.71%,respectively.It can be seen that the AGD of type d increased the most,and the AGD of type b increased the least(P<0.05).The AGD values of the unaffected side and the affected side in each age group had statistically significant differences within and between groups(P<0.05).Among them,AGD of patients older than 70 years increased the most and AGD of patients aged 41 to 50 increased the least.There was a statistical difference(P<0.05).Conclusion:In mammography,the radiation dose of affected side is not only related to breast density and compression thickness,but also related to whether there are lumps in breast.Moreover,the AGD of the affected breast is higher than that of the unaffected side,and there are also differences in radiation doses between different age groups.
作者
鲍文宪
沈茜刚
郑晓静
杨孟
顾雅佳
BAO Wenxian;SHEN Xigang;ZHENG Xiaojing;YANG Meng;GU Yajia(Department of Diagnostic Radiology,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)
出处
《肿瘤影像学》
2022年第6期581-585,共5页
Oncoradiology
