Neeter Lidewij M F H, Raat H P J Frank, Alcantara Rodrigo, Robbe Quirien, Smidt Marjolein L, Wildberger Joachim E, Lobbes Marc B I
Department of Medical Imaging, Laurentius Hospital, Roermond, the Netherlands.
Department of Radiology, Hospital del Mar, Barcelona, Spain.
BJR Open. 2021 Nov 24;3(1):20210034. doi: 10.1259/bjro.20210034. eCollection 2021.
Contrast-enhanced mammography (CEM) is a combination of standard mammography and iodinated contrast material administration. During the last decade, CEM has found its place in breast imaging protocols: after i.v. administration of iodinated contrast material, low-energy and high-energy images are retrieved in one acquisition using a dual-energy technique, and a recombined image is constructed enabling visualisation of areas of contrast uptake. The increased incorporation of CEM into everyday clinical practice is reflected in the installation of dedicated equipment worldwide, the (commercial) availability of systems from different vendors, the number of CEM examinations performed, and the number of scientific articles published on the subject. It follows that ever more radiologists will be confronted with this technique, and thus be required to keep up to date with the latest developments in the field. Most importantly, radiologists must have sufficient knowledge on how to interpret CEM images and be acquainted with common artefacts and pitfalls. This comprehensive review provides a practical overview of CEM technique, including CEM-guided biopsy; reading, interpretation and structured reporting of CEM images, including the accompanying learning curve, CEM artefacts and interpretation pitfalls; indications for CEM; disadvantages of CEM; and future developments.
对比增强乳腺摄影（CEM）是标准乳腺摄影与碘化造影剂注射的结合。在过去十年中，CEM在乳腺成像方案中占据了一席之地：静脉注射碘化造影剂后，使用双能技术在一次采集中获取低能量和高能量图像，并构建重组图像以实现对比剂摄取区域的可视化。CEM在日常临床实践中的应用增加体现在全球范围内专用设备的安装、不同供应商系统的（商业）可用性、CEM检查的执行数量以及关于该主题发表的科学文章数量上。因此，越来越多的放射科医生将面临这项技术，从而需要跟上该领域的最新发展。最重要的是，放射科医生必须具备足够的知识来解读CEM图像，并熟悉常见的伪影和陷阱。这篇综述全面介绍了CEM技术，包括CEM引导下的活检；CEM图像的阅读、解读和结构化报告，包括伴随的学习曲线、CEM伪影和解读陷阱；CEM的适应证；CEM的缺点；以及未来的发展。
