From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.
Radiographics. 2017 Nov-Dec;37(7):1913-1927. doi: 10.1148/rg.2017170032.
Synthetic mammography (SM) consists of two-dimensional images reconstructed from digital breast tomosynthesis (DBT) data. Unlike standard full-field digital mammography (FFDM), SM does not require additional radiation exposure. SM is being introduced in breast imaging centers because early clinical data demonstrate that synthetic images are comparable to FFDM in cancer detection, positive predictive values, and recall rates. SM has completely replaced FFDM in some practices. Thus, an understanding of SM and its strengths and weaknesses compared with those of FFDM is essential. The artifacts of SM include blurring subcutaneous tissue, loss of resolution in the axilla on mediolateral oblique views, pseudocalcifications, and decreased resolution near foreign bodies (eg, biopsy markers). SM's strengths include a reduced radiation dose, shorter acquisition time compared with a combined FFDM/DBT screening examination (with potentially less motion artifact), and increased conspicuity of calcifications, spiculated margins, and architectural distortion. The weaknesses of SM include the potential for false positives due to pseudocalcifications and the difficulty in assessing for motion artifact. This article reviews SM and its role in screening and presents clinical cases to highlight SM's strengths, weaknesses, and artifacts. RSNA, 2017.
合成乳腺摄影术（SM）由数字乳腺断层合成（DBT）数据重建的二维图像组成。与标准全视野数字乳腺摄影术（FFDM）不同，SM 不需要额外的辐射暴露。SM 正在乳腺成像中心推出，因为早期的临床数据表明，合成图像在癌症检测、阳性预测值和召回率方面与 FFDM 相当。在某些实践中，SM 已经完全取代了 FFDM。因此，了解 SM 及其与 FFDM 的优缺点至关重要。SM 的伪影包括皮下组织模糊、侧斜位腋窝分辨率降低、假钙化和异物（如活检标记）附近分辨率降低。SM 的优势包括辐射剂量降低、与 FFDM/DBT 联合筛查检查相比采集时间缩短（潜在运动伪影减少），以及钙化、刺状边缘和结构扭曲的显示度增加。SM 的弱点包括由于假钙化导致的假阳性的可能性以及评估运动伪影的困难。本文回顾了 SM 及其在筛查中的作用，并展示了临床病例，以突出 SM 的优势、弱点和伪影。RSNA，2017 年。
