Griffith Brandy M, Taylor Clayton R, Hawley Jeffrey R, Chauhaun Nirav M, Klonk Ian C, Ferguson Candise, Patel Mitva J
From the Department of Radiology, The Ohio State University Wexner Medical Center, 395 W 12th Ave, #4, Columbus, OH 43210-1240.
Radiographics. 2025 Nov;45(11):e240136. doi: 10.1148/rg.240136.
Contrast-enhanced mammography (CEM) is a functional imaging study performed by using intravenously administered iodinated contrast material and digital mammography equipment to acquire low- and high-energy images directly after each other and during the same breast compression. The images are processed using a weighted subtraction to obtain the contrast-enhanced image-also called the recombined image-on which areas of enhancement are visualized. Much like MRI, CEM with intravenous contrast material provides enhancement that improves diagnostic accuracy compared with that achieved with standard mammography and has sensitivity and specificity for cancer detection similar to those of MRI. The use of CEM has increased in part due to its accessibility and ease of use, making it essential that radiologists become familiar with interpreting and reporting CEM findings. Becoming educated on this examination is essential, and adoption of the associated lexicon is critical to facilitating standardized reporting and effective communication between radiologists and clinicians. Learning to read CEM images can be straightforward, especially when radiologists apply their knowledge of and experience with full-field digital mammography and MRI to CEM. Using the American College of Radiology CEM supplement and the fifth edition of the Breast Imaging Reporting and Data System (BI-RADS) manual, the authors systematically review the similarities and differences between the CEM lexicon and the existing mammography and MRI lexicons, providing a framework for radiologists who interpret and report on CEM cases. In addition, they discuss the potential limitations of CEM and the role of this examination in common and challenging diagnostic scenarios. RSNA, 2025.
对比增强乳腺摄影（CEM）是一种功能成像检查，通过静脉注射碘化造影剂并使用数字乳腺摄影设备，在相同的乳房压迫过程中依次直接获取低能量和高能量图像。图像通过加权相减进行处理，以获得对比增强图像（也称为重组图像），在该图像上可显示增强区域。与MRI非常相似，静脉注射造影剂的CEM提供的增强效果与标准乳腺摄影相比提高了诊断准确性，并且对癌症检测的敏感性和特异性与MRI相似。CEM的使用有所增加，部分原因是其可及性和易用性，这使得放射科医生熟悉解读和报告CEM结果变得至关重要。接受关于此项检查的教育至关重要，采用相关术语对于促进标准化报告以及放射科医生与临床医生之间的有效沟通至关重要。学习解读CEM图像可以很直接，尤其是当放射科医生将其在全视野数字乳腺摄影和MRI方面的知识和经验应用于CEM时。作者使用美国放射学会CEM补充材料和《乳腺影像报告和数据系统（BI-RADS）》手册第五版，系统地回顾了CEM术语与现有的乳腺摄影和MRI术语之间的异同，为解读和报告CEM病例的放射科医生提供了一个框架。此外，他们还讨论了CEM的潜在局限性以及此项检查在常见和具有挑战性的诊断场景中的作用。RSNA，2025年。
