Phillips Jordana, Fein-Zachary Valerie J, Slanetz Priscilla J
Beth Israel Deaconess Medical Center, Department of Diagnostic Radiology, Boston, MA.
J Breast Imaging. 2019 Mar 13;1(1):64-72. doi: 10.1093/jbi/wby013.
Contrast-enhanced mammography (CEM) is a promising new imaging modality that uses a dual-energy acquisition to provide both morphologic and vascular assessment of breast lesions. Although no official BI-RADS lexicon exists, interpretation entails using the mammographic BI-RADS lexicon in combination with that for breast MRI. CEM has comparable performance to breast MRI, with sensitivity of 93-100% and specificity of 80-94%. Currently FDA approved for diagnostic imaging, this technology can be helpful in determining disease extent in patients with newly diagnosed breast malignancy, monitoring response to neoadjuvant therapy, identifying mammographically occult malignancies, and diagnostic problem-solving. Studies are ongoing about its role in screening, especially in women with dense breasts or at elevated risk. There are some challenges to successful implementation into practice, but overall, patients tolerate the study well, and exam times are less than the full breast MRI protocol.
对比增强乳腺摄影（CEM）是一种很有前景的新型成像方式，它采用双能量采集来提供乳腺病变的形态学和血管评估。尽管目前尚无官方的乳腺影像报告和数据系统（BI-RADS）词典，但解读时需要将乳腺摄影的BI-RADS词典与乳腺磁共振成像（MRI）的词典结合使用。CEM的性能与乳腺MRI相当，灵敏度为93%-100%，特异性为80%-94%。该技术目前已获得美国食品药品监督管理局（FDA）批准用于诊断成像，有助于确定新诊断乳腺恶性肿瘤患者的疾病范围、监测新辅助治疗的反应、识别乳腺摄影隐匿性恶性肿瘤以及解决诊断问题。关于其在筛查中的作用，尤其是在乳腺致密或风险较高的女性中的作用，相关研究正在进行。在实际应用中成功实施存在一些挑战，但总体而言，患者对该检查耐受性良好，且检查时间比完整的乳腺MRI方案短。
