对比增强乳腺钼靶摄影在乳腺病变评估中的效能：初步经验
Efficacy of Contrast-Enhanced Mammography in the Evaluation of Breast Lesions: An Initial Experience.
作者信息
Chigurupati Rajendhar, R Lekshmy, Tk Vidya, Kulkarni Chinmay
机构信息
Radiology, Amrita Vishwa Vidyapeetham Healthcare Campus, Kochi, IND.
出版信息
Cureus. 2025 Jul 8;17(7):e87566. doi: 10.7759/cureus.87566. eCollection 2025 Jul.
INTRODUCTION
Contrast-enhanced mammography (CEM) is an emerging technique for evaluating breast lesions. It is practiced in a few centers and is mostly used as a problem-solving tool in clinical practice and for therapeutic planning of breast cancer.
OBJECTIVES
This study aimed to evaluate the efficacy of CEM in the detection and characterization of breast lesions.
METHODS
We retrospectively evaluated 142 patients (mean age 50 +/- 25 years) who underwent technically successful CEM for the characterization of breast lesions between February 2023 and October 2023. Out of 142 patients, 96 patients (108 lesions) who had histopathology correlation were included for analysis. The patients with no histopathology were excluded. CEM was performed using a Siemens Healthineers Mammomat Revelation machine (Erlangen, Germany). A 1.5 ml/kg body weight of iodinated contrast media (Omnipaque 350, GE Healthcare, Chicago, IL) was intravenously injected at a rate of 3.5 mL/sec. Both low-energy (28-32 kVp) and high-energy (45-49 kVp) images of the cranio-caudal and mediolateral projections were acquired two to eight minutes after injection. Images were analyzed by two breast radiologists on a dedicated workstation (MedMammo (Medecom, Plougastel-Daoulas, France) and BARCO (Barco NV, Kortrijk (Courtrai), Belgium)).
RESULTS
The overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CEM for characterizing the breast lesions were 78.6%, 100%, 100%, and 71.7%, respectively. Out of 108 lesions, 70 were malignant and 38 were benign. Among 70 malignant lesions, 55 lesions showed enhancement with washout, and 14 showed only enhancement with no washout. One malignant lesion showed no enhancement. Out of 38 benign lesions, 29 showed enhancement with no washout, and nine did not show enhancement.
CONCLUSION
CEM showed good sensitivity and specificity in the detection and characterization of breast lesions.
引言
对比增强乳腺钼靶摄影（CEM）是一种用于评估乳腺病变的新兴技术。该技术仅在少数中心开展，在临床实践中主要用作解决问题的工具以及用于乳腺癌的治疗规划。
目的
本研究旨在评估CEM在检测和鉴别乳腺病变方面的有效性。
方法
我们回顾性评估了2023年2月至2023年10月期间142例（平均年龄50±25岁）接受技术上成功的CEM以鉴别乳腺病变的患者。在142例患者中，96例（108个病变）有组织病理学相关性的患者被纳入分析。无组织病理学结果的患者被排除。使用西门子医疗的Mammomat Revelation机器（德国埃尔朗根）进行CEM。以3.5 mL/秒的速率静脉注射1.5 ml/kg体重的碘化造影剂（欧乃派克350，通用电气医疗集团，伊利诺伊州芝加哥）。在注射后两至八分钟采集头尾位和内外侧斜位的低能（28 - 32 kVp）和高能（45 - 49 kVp）图像。由两名乳腺放射科医生在专用工作站（MedMammo（法国普卢加斯特尔 - 道拉斯的Medecom公司）和BARCO（比利时科特赖克的Barco NV公司））上对图像进行分析。
结果
CEM鉴别乳腺病变的总体敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为78.6%、100%、100%和71.7%。在108个病变中，70个为恶性，38个为良性。在70个恶性病变中，55个病变表现为强化并廓清，14个仅表现为强化而无廓清。1个恶性病变无强化。在38个良性病变中，29个表现为强化而无廓清，9个无强化。
结论
CEM在检测和鉴别乳腺病变方面显示出良好的敏感性和特异性。
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