摘要
目的比较增感屏-胶片乳腺X线摄影、数字乳腺摄影（DR）和计算机乳腺摄影（CR）3种系统的模体影像质量、辐射剂量和临床对疾病诊断的准确率。方法选择3台临床使用中的屏-胶片、DR和CR乳腺摄影设备，进行性能测试，确保质量符合规定，具有可比性。以屏-胶片系统的辐射剂量为标准，使用DR和CR分别对Mammo-152模体和美国放射学院（ACR）模体摄影。再使用DR和CR的最优模式对模体摄影并记录辐射剂量。所获图像照片按模拟病变结构编号，由8名专业乳腺放射学医师在相同条件下分别进行ACR评分。3种方法的评分结果采用随机区组设计的方差分析进行统计学处理。连续收集一段时期内采用3种检查方法检查，并且有病理诊断结果的患者的影像资料，应用Kappa检验方法进行2种诊断结果一致性检验，并以病理结果为金标准，比较3种影像检查结果诊断的准确率。结果对于Mammo-152模体，无论DR、CR的辐射剂量是否超过屏．胶片乳腺x线摄影的2．25mGy乳腺平均剂量，屏-胶片摄影的空间分辨率都最高（7．0～8．0Lp／mm），DR次之（4．7—5．2Lp／mm），CR最差（2．5Lp／mm）。增加辐射剂量（27．0％-30．0％），DR的空间分辨率略有改善（上升11．0％），而CR几乎没有改变（上升1．5％）。对ACR模体摄影时，DR的辐射剂量没有超过屏．胶片乳腺X线摄影的2．22mGy乳腺平均剂量，且模拟结构显示度最好。屏．胶片乳腺x线摄影的团块显示优于CR，但CR的纤维和点阵显像优于屏-胶片乳腺x线摄影。CR检查时辐射剂量提高25．0％，纤维和点阵显像接近DR，团块显像接近屏-胶片乳腺x线摄影。3台设备的x线诊断和病理诊断结果的一致性极好（屏-胶片系统的一致率50／56，DR系统83／90，CR系统61／69，P值均〈0．01且Kappa值均〉0．75），在疾病诊断准确率上差异没有统计学意义[屏-胶�
Objective To compare the image quality, radiation dose and diagnostic accuracy on film-screen, digital radiography （DR） and computed radiography （CR） mammography. Methods Three different kinds of mammography machines （film-screen, DR and CR） were tested to make sure they were qualified and comparable. Radiographies were taken on Mammo-152 phantom and ACR phantom using filmscreen, DR and CR systems with the same radiation dose. Next, radiographies were taken on two phantoms using DR and CR systems with classic mode or AEC and the radiation dose was recorded. The images were numbered and scored by eight independent experienced radiologists under the same reading condition according to ACR method. Statistics was performed with the randomized complete-block design variance analysis. The diagnostic accuracy of three kinds of mammography methods were compared with Kappa test in clinical cases who had pathologic results. Results The spacial resolution of film-screen system was the highest （7. 0-8. 0 Lp/mm） and that of CR was the lowest （2.5 Lp/mm）. When the radiation dose was increased （27.0%-30. 0% ）, the resolution was improved with DR （ ＋ 11.0% ） but almost no change with CR （ ＋ 1.5% ）. The radiation dose of DR was the lowest on ACR phantom. The delineation of mass was better on film-screen than on CR, but the delineation of fibers and speck was better on CR. When the radiation dose of CR was increased （25. 0% ）, the delineation of fibers and speck on CR was similar to that on DR and the delineation of mass was similar to that on film-screen. There was a good correlation between the mammography diagnosis and pathological results （film-screen is 50/56, DR is 83/90 and CR is 61/69, P 〈 0. 01 and Kappa value 〉 0. 75 ）. The diagnostic accuracy of three mammography systems had no statistical difference [ film-screen 89. 3% （50/56）, DR 92. 2% （83/90） and CR 88.4% （61/69）, Pearson X2 = 0. 722,P = 0. 697 ]. Conclusion Film/screen system has the highest space resolut
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2010年第7期735-740,共6页
Chinese Journal of Radiology
基金
山西省回国留学人员科研项目（200678）
关键词
乳房X线摄影术
辐射剂量
诊断技术和方法
模拟结构影像质量
Mammography
Radiation dosage
Diagnostic techniques and procedures
Image quality of simulated fabrics
