優化乳房放大攝影影像品質降低重照率

乳房攝影（mammography）能找出無法觸診摸到及超音波無法偵測到的微鈣化點群，而微鈣化點群可能是早期乳癌的徵兆，藉此達到早期診斷早期治療的目的，降低乳癌的死亡率。乳房攝影檢查雖對早期乳癌具有高敏感度並且影像解析度高，但會使受檢者於檢查時吸收輻射劑量，國內外許多文獻指出，過多輻射劑量的吸收會提高罹癌的風險，尤其是因乳房主要組成的結構為軟組織，較一般身體組織更容易產生病變。適切的乳房X光攝影擺位能使乳房組織充分呈現於影像中而不遺漏，長期以來多數研究與統計也都證實乳房擺位是影響乳房X光攝影檢查成效的關鍵因素。作為疑似病灶的進一步措施，儘管乳房放大攝影的平均乳腺劑量比一般乳房攝影為高，但是乳房放大攝影提供了較高的解析度和病灶鮮銳度，所以降低乳房放大攝影的重照率相對重要。本文根據研究分析成果搭配品管圈手法得到建立了外院片標準化流程，輔以放射師的基本擺位與進階判片教育訓練，加上統一量測工具、三角座標量測法，有效將乳房放大攝影重照率由38.42%降至24.1%，提升整體乳房攝影影像品質，加速臨床工作的醫療正確性，提升整體醫療品質。

關鍵字

乳房放大攝影；人為因素；品管圈；重照率

並列摘要

Mammography can identify the incapable palpation object and avoid microcalcifications which is undetectable by ultrasound, however microcalcification clusters is likely the sign of breast cancer in the early stage, to achieve the purpose of early diagnosis, early treatment and reduce the mortality rate of breast cancer. Mammography is with high sensitivity and high image resolution to breast cancer in the early stage, but it will increase the radiation dose to patients during the inspection. Many domestic and foreign literature indicate that it will increase the risk of cancer when patients absorb excessive radiation dose, especially the main composition of breast is soft tissue, it is easier to cause pathological changes compared to general body tissue. Proper mammography positioning enables breast tissue to be fully represented in the image without being missed. In the long term, most studies and statistics have confirmed that breast positioning is a key factor affecting the effectiveness of mammography. As a further measure for suspected lesions, even if the average breast dose for mammography is higher than for general mammography, mammography provides high resolution and sharpness, it is relatively crucial to reduce the retaking rate of mammography. According to the research and analysis results in this article, it establishes a standard process to outside film, it effectively reduces the retaking rate of enlargement mammography from 38.42% to 24.10% by proper positioning of the radiologist, plus the unified measurement tool and trigonometric measurement, it enhances the image quality of mammography, and improves the medical accuracy and quality.

並列關鍵字

spot compression magnification view ； human factors ； Image Reject Rate ； Quality Control Circle Technique

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