Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
Diagn Interv Imaging. 2019 Oct;100(10):593-605. doi: 10.1016/j.diii.2019.01.011. Epub 2019 Apr 5.
Although mammography is currently the imaging technique of choice for screening and diagnosis, it has some limitations, especially in patients with high-density breasts. The evolution from film screen to full-field digital mammography has recently led to the development of new imaging techniques, which are less expensive and widely available. Contrast-enhanced spectral mammography (CESM) is one of them, coupling X-ray breast imaging to the intravenous administration of an iodinated contrast material. CESM provides both morphological information, similar to mammography, and functional information of tumor perfusion. In this review, the imaging technique, the specificity of interpretation of CESM compared to MRI and the currently available data are presented. The clinical performances of CESM versus those of mammography and MRI and its additional value in preoperative local assessment and screening is discussed. The potential advantages and disadvantages are mentioned and we also discuss how CESM contributes to the detection of lesions and how it can be used in daily clinical workflow.
虽然乳腺 X 线摄影术目前是筛查和诊断的首选影像学技术，但它存在一些局限性，特别是在乳腺密度高的患者中。从胶片屏到全数字化乳腺 X 线摄影术的发展最近带来了新的成像技术，这些技术成本更低，应用更广泛。对比增强光谱乳腺摄影术（CESM）就是其中之一，它将 X 射线乳腺成像与静脉内给予碘造影剂相结合。CESM 提供类似于乳腺 X 线摄影术的形态学信息和肿瘤灌注的功能信息。在这篇综述中，介绍了成像技术、CESM 与 MRI 相比的解读特异性以及目前可用的数据。讨论了 CESM 与乳腺 X 线摄影术和 MRI 的临床性能及其在术前局部评估和筛查中的附加价值。还提到了潜在的优点和缺点，并讨论了 CESM 如何有助于检测病变以及如何在日常临床工作流程中使用。
