乳房植入物劑量與影像品質之探討分析

Analysis of dosage and image quality for breast implant

黃東珊(Dong-Shan Huang) ； 郭宗德(Tsung-Ter Kuo) ； 林宜美(I-Mei Lin) ； 魏毓芬(Yuh-Fen Wei) ； 張淑宜(Shu-Yi Zhang)

《加馬》 50期 (2019/12) Pp. 17-25

摘要

根據2017年台灣衛生福利部統計資料指出，乳癌是台灣十大癌症死亡第四位更是女性癌症第一位。因近年醫學美容快速進展，婦女隆乳人數有增加趨勢。很多婦女因擔憂做乳房攝影篩檢而造成植入物破裂，且植入物在X光下無法完全穿透進而掩蓋植入物下的乳腺病灶，增加篩檢難度。現今乳房攝影大多使用自動曝射系統照射，乳房植入物不易穿透，且會因為材質的不同其所需的劑量也不同，故需手動調整劑量。原廠建議照射參數設定值與實際臨床使用劑量相比，原廠建議照射劑量過低並無法提供具診斷價值影像。本研究以組織補償物模擬人體乳房組織取代品保使用的硬式假體PMMA並加入不同材質之植入物（矽膠植入物，鹽水袋）來評估各種曝射條件下的影像，建構出最佳化的乳房植入物影像條件與合理的平均乳腺劑量，以供臨床執行攝影時的參考基準。

關鍵字

乳房植入物 ； 矽膠植入物 ； 鹽水袋 ； 組織補償物 ； 平均乳腺劑量

並列摘要

According to the statistics of the Taiwan Ministry of Health and Welfare in 2017, breast cancer is the fourth largest cancer death in Taiwan and the first female cancer. Due to the rapid progress of medical beauty in recent years, the number of women with breast augmentation has increased. Many women suffer from rupture of the implant due to concerns about mammography screening, and the implant does not penetrate completely under X-rays to cover the breast lesions under the implant, increasing the difficulty of screening. However, most of today's mammography uses Automatic Exposure System (AEC) illumination, but breast implants are not easy to penetrate, and the required dose varies depending on the material, so it is necessary to manually adjust the dose. Compared with the actual clinical dose, the original recommended set value is too low to provide a diagnostic value image, and the original factory does not provide post-compression illumination parameters. Simulated human breast tissue replaces the rigid prosthesis PMMA used by the product with Bolus and adds implants of different materials to evaluate images under various exposure conditions to construct an optimized breast implant image. These conditions will provide reference for radiologist when performing clinically photography.

並列關鍵字

breast implant ； tissue compensator ； saline bag ； silicone implant ； average glandular dose