CAJ | 학술논문

目的探讨乳腺筛查X射线摄影参数对辐射剂量与影像质量的影响,以获取辐射剂量与影像质量的最佳匹配.方法回顾性分析接受数字乳腺X射线筛查摄影的507例受检者的曝光参数与平均腺体剂量的相关性.对不同厚度的亚克力板进行曝光,获取乳腺压迫厚度对辐射剂量的影响.通过对比度细节测试模体( CDMAM3.4)与不同厚度亚克力板的组合测试,分析其与影像质量的相关性.结果在507例受检者中,30～49岁为乳腺筛查影像受检者的主体人群,占67.06％.3种曝光模式下,平均腺体剂量(AGD)的均值以对比度优先模式最高,为标准模式的137.5％.标准模式靶物质/滤过板组合是Mo/Mo、Mo/Rh、Rh/Rh共3种,各占1/3；剂量优先模式选择的是Mo/Rh、Rh/Rh 2种组合,各占50％；对比度优先模式则以选择Mo/Mo组合为主,占52％.乳腺压迫厚度与平均腺体剂量之间均呈正相关.3种曝光模式的逆影像质量指数( IQFinv)分别为98.32、95.41和107.02,其中对比度优先模式的IQFinv值最高；但当亚克力板增加到≥5 cm时,3种曝光模式下的IQFinv值很接近.结论当受检者乳腺属于致密型乳腺且压迫厚度＜4 cm时,应选择剂量优先曝光模式；＞4 cm而＜6 cm时,选择标准曝光模式；＞6 cm选择手动.
목적 탐토유선사사X사선섭영삼수대복사제량여영상질량적영향,이획취복사제량여영상질량적최가필배.방법 회고성분석접수수자유선X사선사사섭영적507례수검자적폭광삼수여평균선체제량적상관성.대불동후도적아극력판진행폭광,획취유선압박후도대복사제량적영향.통과대비도세절측시모체( CDMAM3.4)여불동후도아극력판적조합측시,분석기여영상질량적상관성.결과 재507례수검자중,30～49세위유선사사영상수검자적주체인군,점67.06％.3충폭광모식하,평균선체제량(AGD)적균치이대비도우선모식최고,위표준모식적137.5％.표준모식파물질/려과판조합시Mo/Mo、Mo/Rh、Rh/Rh공3충,각점1/3；제량우선모식선택적시Mo/Rh、Rh/Rh 2충조합,각점50％；대비도우선모식칙이선택Mo/Mo조합위주,점52％.유선압박후도여평균선체제량지간균정정상관.3충폭광모식적역영상질량지수( IQFinv)분별위98.32、95.41화107.02,기중대비도우선모식적IQFinv치최고；단당아극력판증가도≥5 cm시,3충폭광모식하적IQFinv치흔접근.결론 당수검자유선속우치밀형유선차압박후도＜4 cm시,응선택제량우선폭광모식；＞4 cm이＜6 cm시,선택표준폭광모식；＞6 cm선택수동.
Objective To obtain the matched parameters between image quality and radiation dose by exploring the influence of the exposure parameters of screening mammography on both the image quality and radiation dose.Methods The correlation between the exposure parameters and average glandular doses to 507 patients undergoing screening mammography were retrospectively analyzed.The influence of breast compression thickness on radiation dose by exposing different thickness of PMMA was obtained.The correlation with image quality was analyzed by combined testing of contrast detail test mode ( CDMAM3.4 )and different thickness of PMMAs.Results The groups aged 30 to 49 years were the main groups in 507examined patients,up to 67.06％ of the total.The mean value of average gland doses ( AGD ) in contrastprior mode was the highest in three kinds of exposure modes,accounting for 137.5％ of standard mode.In standard mode,target material/filtration board combination was Mo/Mo,Mo/Rh and Rh/Rh,accounting for 1/3 respectively.Mo/Rh and Rh/Rh were selected in dose-prior mode,accounting for 50％ respectively.Mo/Mo was mainly selected in contrast-prior,accounting for 52％.Breast compression thickness was positively correlated with average gland doses.Image quality figure inverse (IQFinv) under three kinds of modes (STD,DOSE,CNT) was 98.32,95.41 and 107.02,respectively,and IQFinv of contrast-prior mode was the highest among them.IQFinv was in general agreement in the three kinds of exposure modes when the thickness of PMMA plates plates was greater than or equal to 5 cm.Conclusions In clinical practice,when the breast is of density type and pressed thickness is less than 4 em,the dose-prior mode should be selected.When the pressed thickness is between 4 and 6 cm,the standard exposure mode should be selected.When the pressed thickness is larger than 6 cm,the manual mode should be selected.