自我壓迫裝置執行乳房攝影：改善疼痛成效之探討

Impact of Self-compression Technique on Mammography: Comparison with Technologist Compression

吳亭瑤(Ting-Yao Wu) ； 湯雅君(Ya -Chun Tang) ； 謝慧茹(Hui Ju Hsieh) ； 張潤忠(Yun-Chung Cheung)

《中華放射線技術學雜誌》 44卷1期 (2020/03) Pp. 22-28

摘要

目的：自主加壓控制器（patient assistant compression, PAC），可依據受檢者對於疼痛耐受度差異由受檢者決定最終壓迫力道，以減輕受檢者於檢查時不適感。本研究目的為評估運用PAC於常規乳房攝影檢查時是對於檢查報告嚴重度分級（breast imaging reporting and data system, BIRADS）、乳房密度分析、壓迫力道、疼痛感受和受檢意願是否有影響。材料與方法：本試驗於2019年1月至2019年5月排共收集58受試者（平均年齡為55±7歲；範圍：45-73歲）於林口長庚醫院使用接受乳房攝影（Senographe Pristina），並和前次未使用PAC時之影像做比較。受試者每一側乳房皆接受1張頭尾像和1張斜位像照攝，檢查時先由放射師壓迫乳房至10daN後再由受試者使用PAC決定最終壓迫乳房力道，並於檢查結束後接受進行疼痛評估。結果：經由統計分析顯示，受檢者執行乳房攝影時壓迫力道和乳房密度分析與受檢者是否使用PAC無顯著相關（p = 0.104; p = 0.4）。雖然使用PAC乳房壓迫厚度稍微增加（p=0.21），但74%受檢者疼痛評估明顯低於未使用PAC。比較兩種不同壓迫方式之檢查報告嚴重度BIARADS分級，1位受檢者於使用PAC時其分級為0但前次檢查為2，另外有6位受檢者於傳統乳攝BIRADS分級為0但使用PAC時為2。而96%受檢者表示使用PAC可提升再受檢意願。結論：PAC可降低乳攝檢查之不適感並提升再受檢意願，同時並不會影響檢查結果嚴重度分級。

關鍵字

乳房攝影 ； 乳房壓迫力道 ； 減輕疼痛

並列摘要

Introduction: New feature of patient-assisted compression (PAC) allows patients determining the level of breast compression during mammography by herself with the remote control. This study evaluate the impact of PAC on BIARADS (breast imaging reporting and data system), breast density, compression force, patient experience and reattendance rate on mammography. Materials and Methods: 58 patients underwent bilateral mammography were enrolled (mean age: 55±7, range: 45-73) in this prospectively study and performed mammography with standard compression executed by technologists 1-2 years before they examined again with PAC. All patients were received two views, a craniocaudal (CC) view and mediolateral oblique (MLO) view for each breast. When performing with PAC, the technologist initially compress10 daN, and then patients used PAC remote control to finalize compression when the pain sensation is not acceptable. Result: There were no significant difference in compression force and breast density between PAC and standard compression (p = 0.104,p =0.4). The compression thickness with PAC were slightly thicker than with standard compression(p=0.21) However, the pain experience for mammography was significantly different by using PAC and standard compression(p＜.01). 74% patients perceived painless in mammography via PAC. In terms of comparing individual BIRADS risk stratification between PAC and standard compression, most patients showed comparable results except seven patients: one patient was evaluated as category 0 via PAC but as category 2 in standard compression, while six patients were evaluated as category 0 via standard compression but as category 2 via PAC. Moreover, reattendance rate was significantly increased with PAC versus standard compression. Ninety-six percent (56/58) participants reported that the remote self-control PAC device would facilitate reattendance for mammography. Conclusion: PAC can improve patient experience during mammography as well as provide comparable BIRADS risk stratification in the preliminary results. This device may provide favorable option for women who want to perform mammography.

並列關鍵字

mammography ； compression force ； reduced pain