关键词: 对比增强能谱乳腺X线摄影, 乳腺影像报告和数据系统, 对比剂

Abstract: The purpose of the study is to explore the enhancement characteristics of contrast-enhanced spectral mammography and its diagnostic effect for breast imaging reporting and date system(BI-RADS)category 4 breast lesions. 60 patients whose lesions were categorized as BI-RADS 4 in CESM examination were recruited, and a total of 60 lesions were detected using pathology results as the gold standard, including 27 malignant lesions and 33 benign lesions. Signal values of ROI in CESM were measured, including lesions of craniocaudal (CC), mediolateral obliqde (MLO) and background, then percentage 876 difference (RS%) and contrast noise ratio (CNR) between lesions and background were calculated. According to the enhancement difference of lesions between two postures, the enhancement types were divided into:persistent (type Ⅰ), plateau (type Ⅱ), and washout (type Ⅲ). The difference of intensification degree and intensification type between the benign and malignant groups were compared, respectively. The results showed that there was no significant difference in RS% and CNR between malignant and benign lesions (P>0.05). 87% lesions were benign and 13% were malignant in type Ⅰ, 55.6% were benign and 44.4% were malignant in type Ⅱ, 15.8% were benign and 84.2% were malignant in type Ⅲ. Benign lesions were usually of type Ⅰ and type Ⅱ, and malignant lesions were of type Ⅱ and type Ⅲ. The difference between two groups was statistically significant. In conclusion, the enhanced type analysis could provide certain basis for identifying the benign and malignant types of BI-RADS category 4 lesions in CESM.

Key words: contrast-enhanced spectral mammography, breast imaging reporting and date system, contrast agents