中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2010年
7期
735-740
,共6页
李力敏%赵晚苗%张飚慷%闫建文%范秀丽
李力敏%趙晚苗%張飚慷%閆建文%範秀麗
리력민%조만묘%장표강%염건문%범수려
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
乳房X線攝影術%輻射劑量%診斷技術和方法%模擬結構影像質量
유방X선섭영술%복사제량%진단기술화방법%모의결구영상질량
Mammography%Radiation dosage%Diagnostic techniques and procedures%Image quality of simulated fabrics
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Manuno-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一胶片乳腺X线摄影的2.25 mGy乳腺平均剂量,屏-胶片摄影的空间分辨率都最高(7.0～8.0 Lp/mm),DR次之(4.7～5.2 Lp/mm),CR最差(2.5 Lp/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2.22 mGy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-胶片系统的准确率为89.3%(50/56),DR系统为92.2%(83/90),CR系统为88.4%(61/69),PearsonX2值为0.722,P=0.697].结论 屏-胶片乳腺X线摄影分辨率最高,DR的模拟病变显像最好且辐射剂量最低.当CR的辐射剂量与屏-胶片乳腺X线摄影相当时,两者对模拟病变的显像各有优劣;当增加CR的摄影剂量时,其模拟结构显像质量高于屏-胶片乳腺X线摄影,低于DR.在临床对疾病的诊断准确率方面,三者无明显差别.
目的 比較增感屏-膠片乳腺X線攝影、數字乳腺攝影(DR)和計算機乳腺攝影(CR)3種繫統的模體影像質量、輻射劑量和臨床對疾病診斷的準確率.方法 選擇3檯臨床使用中的屏-膠片、DR和CR乳腺攝影設備,進行性能測試,確保質量符閤規定,具有可比性.以屏-膠片繫統的輻射劑量為標準,使用DR和CR分彆對Manuno-152模體和美國放射學院(ACR)模體攝影.再使用DR和CR的最優模式對模體攝影併記錄輻射劑量.所穫圖像照片按模擬病變結構編號,由8名專業乳腺放射學醫師在相同條件下分彆進行ACR評分.3種方法的評分結果採用隨機區組設計的方差分析進行統計學處理.連續收集一段時期內採用3種檢查方法檢查,併且有病理診斷結果的患者的影像資料,應用Kappa檢驗方法進行2種診斷結果一緻性檢驗,併以病理結果為金標準,比較3種影像檢查結果診斷的準確率.結果 對于Mammo-152模體,無論DR、CR的輻射劑量是否超過屏一膠片乳腺X線攝影的2.25 mGy乳腺平均劑量,屏-膠片攝影的空間分辨率都最高(7.0～8.0 Lp/mm),DR次之(4.7～5.2 Lp/mm),CR最差(2.5 Lp/mm).增加輻射劑量(27.0%～30.0%),DR的空間分辨率略有改善(上升11.0%),而CR幾乎沒有改變(上升1.5%).對ACR模體攝影時,DR的輻射劑量沒有超過屏-膠片乳腺X線攝影的2.22 mGy乳腺平均劑量,且模擬結構顯示度最好.屏-膠片乳腺x線攝影的糰塊顯示優于CR,但CR的纖維和點陣顯像優于屏-膠片乳腺X線攝影.CR檢查時輻射劑量提高25.0%,纖維和點陣顯像接近DR,糰塊顯像接近屏-膠片乳腺x線攝影.3檯設備的X線診斷和病理診斷結果的一緻性極好(屏-膠片繫統的一緻率50/56,DR繫統83/90,CR繫統61/69,P值均<0.01且Kappa值均>0.75),在疾病診斷準確率上差異沒有統計學意義[屏-膠片繫統的準確率為89.3%(50/56),DR繫統為92.2%(83/90),CR繫統為88.4%(61/69),PearsonX2值為0.722,P=0.697].結論 屏-膠片乳腺X線攝影分辨率最高,DR的模擬病變顯像最好且輻射劑量最低.噹CR的輻射劑量與屏-膠片乳腺X線攝影相噹時,兩者對模擬病變的顯像各有優劣;噹增加CR的攝影劑量時,其模擬結構顯像質量高于屏-膠片乳腺X線攝影,低于DR.在臨床對疾病的診斷準確率方麵,三者無明顯差彆.
목적 비교증감병-효편유선X선섭영、수자유선섭영(DR)화계산궤유선섭영(CR)3충계통적모체영상질량、복사제량화림상대질병진단적준학솔.방법 선택3태림상사용중적병-효편、DR화CR유선섭영설비,진행성능측시,학보질량부합규정,구유가비성.이병-효편계통적복사제량위표준,사용DR화CR분별대Manuno-152모체화미국방사학원(ACR)모체섭영.재사용DR화CR적최우모식대모체섭영병기록복사제량.소획도상조편안모의병변결구편호,유8명전업유선방사학의사재상동조건하분별진행ACR평분.3충방법적평분결과채용수궤구조설계적방차분석진행통계학처리.련속수집일단시기내채용3충검사방법검사,병차유병리진단결과적환자적영상자료,응용Kappa검험방법진행2충진단결과일치성검험,병이병리결과위금표준,비교3충영상검사결과진단적준학솔.결과 대우Mammo-152모체,무론DR、CR적복사제량시부초과병일효편유선X선섭영적2.25 mGy유선평균제량,병-효편섭영적공간분변솔도최고(7.0～8.0 Lp/mm),DR차지(4.7～5.2 Lp/mm),CR최차(2.5 Lp/mm).증가복사제량(27.0%～30.0%),DR적공간분변솔략유개선(상승11.0%),이CR궤호몰유개변(상승1.5%).대ACR모체섭영시,DR적복사제량몰유초과병-효편유선X선섭영적2.22 mGy유선평균제량,차모의결구현시도최호.병-효편유선x선섭영적단괴현시우우CR,단CR적섬유화점진현상우우병-효편유선X선섭영.CR검사시복사제량제고25.0%,섬유화점진현상접근DR,단괴현상접근병-효편유선x선섭영.3태설비적X선진단화병리진단결과적일치성겁호(병-효편계통적일치솔50/56,DR계통83/90,CR계통61/69,P치균<0.01차Kappa치균>0.75),재질병진단준학솔상차이몰유통계학의의[병-효편계통적준학솔위89.3%(50/56),DR계통위92.2%(83/90),CR계통위88.4%(61/69),PearsonX2치위0.722,P=0.697].결론 병-효편유선X선섭영분변솔최고,DR적모의병변현상최호차복사제량최저.당CR적복사제량여병-효편유선X선섭영상당시,량자대모의병변적현상각유우렬;당증가CR적섭영제량시,기모의결구현상질량고우병-효편유선X선섭영,저우DR.재림상대질병적진단준학솔방면,삼자무명현차별.
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 X 2=0. 722 ,P =0. 697]. Conclusion Film/screen system has the highest space resolution and DR has the lowest radiation dose. Three mammography systems have the same diagnostic accuracy for breast disease.
