Brandan María-Ester, Ruiz-Trejo César, Verdejo-Silva Maricela, Guevara Martha, Lozano-Zalce Horacio, Madero-Preciado Luis, Martín Julia, Noel-Etienne Louise-Marie, Ramírez-Arias José-Luis, Soto Jesús, Villaseñor Yolanda
Departamento de Física Experimental, Instituto de Física, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.
Arch Med Res. 2004 Jan-Feb;35(1):24-30. doi: 10.1016/j.arcmed.2003.06.008.
Regulations concerning the use of x-rays in medical diagnoses were published in Mexico in 1997. In this work, we evaluate technical aspects of mammography services in the Mexico City area and radiation dose and coincidence between the radiological interpretation by the institution radiologist and by a panel of experts.
Following methodology proposed by the American College of Radiology and the European Community among others, we have evaluated the performance of six mammography systems in Mexico City public and private services. The studied services carry out approximately one half of the mammography studies in the capital's metropolitan area.
The systems comply with 53-82% of a total of 31 applied quality control tests and measurements, which include the mammography unit, x-ray generation, collimation, automatic exposure control, compression devices, grid and image receptor, film processing, darkroom, viewboxes, dose, film rejection, and image quality. The elements that most frequently fail are film processing, darkroom, and light boxes; average ACR phantom score is 11.2 (9.5, 12.0); mean average glandular dose measured with the phantom is 1.00 (0.71-1.15) mGy, and measured in patients is 1.75 (0.3, 4.9) mGy; coincidence between radiologic reports (BI-RADS) by the institution radiologist and a panel of experts is obtained in 35% of studied cases.
Statistical analysis of results indicated that the level of equipment performance is correlated with image quality, image quality estimated by the panel of radiologists is correlated with phantom score, and coincidence in clinical mammography reports is not correlated with equipment performance and appears to depend on the radiologist's experience.
1997年墨西哥发布了关于在医学诊断中使用X射线的规定。在本研究中，我们评估了墨西哥城地区乳腺钼靶检查服务的技术方面、辐射剂量以及机构放射科医生与专家小组的放射学解读之间的一致性。
按照美国放射学会和欧洲共同体等提出的方法，我们评估了墨西哥城公共和私人服务中的六个乳腺钼靶检查系统的性能。所研究的服务机构在首都大都市区进行了约一半的乳腺钼靶检查。
这些系统符合总共31项应用的质量控制测试和测量中的53 - 82%，这些测试和测量包括乳腺钼靶检查设备、X射线产生、准直、自动曝光控制、压迫装置、滤线栅和图像接收器、胶片处理、暗室、观片灯、剂量、胶片拒收和图像质量。最常出现故障的部分是胶片处理、暗室和灯箱；ACR体模平均得分为11.2（9.5，12.0）；用体模测量的平均腺体剂量为1.00（0.71 - 1.15）mGy，在患者中测量的为1.75（0.3，4.9）mGy；在35%的研究病例中，机构放射科医生与专家小组的放射学报告（BI - RADS）之间存在一致性。
结果的统计分析表明，设备性能水平与图像质量相关，放射科医生小组估计的图像质量与体模得分相关，而临床乳腺钼靶检查报告的一致性与设备性能无关，似乎取决于放射科医生的经验。
