Quantitative Analysis Of Enhancement Mode Of Contrast-Enhanced Spectral Mammography Multiphase Photography And Its Diagnostic Efficiency

Objective To evaluate the value of contrast enhanced energy spectrum mammography（CESM）in the quantitative evaluation of breast lesions,and to evaluate the diagnostic efficiencyof MLO radiography on the affected side.Methods 90 patients with definite breast masses in the first people’s Hospital of Yunnan Province from November 2020 to August 2021 were selected.All patients were examined by CESM,and the images of CC,MLO 1 and MLO 2 were collected.The average signal values of lesions and background regions of interest（ROI）were measured,and the signal difference value（RS%）,signal-to-noise-distortion ratio（SDNR）and relative signal difference（RSD）were calculated.According to the difference between MLO 2 and MLO1 enhancement,the enhancement patterns were divided into A,B and C modes.The consistency of the average signal value of ROI among observers and between observers was analyzed,and the differences between RS%,SDNR and enhanced patterns of different pathological types of lesions were compared,and the sensitivity and specificity of the two RSD models in the diagnosis of benign and malignant breast lesions were evaluated.According to the degree of enhancement,it was divided into three types: 1,2 and 3,and the differences between different pathological types and enhancement patterns were compared.Results The average signal value of ROI of lesions was highly consistent within and between observers（ICC > 0.9）.There was no significant difference in RS% and SDNR between benign and non-invasive carcinoma,but there was no significant difference between benign and non-invasive carcinoma.There was significant difference in enhancement patterns between benign and malignant lesions（P < 0.01）.The enhancement patterns of benign lesions were mode An and mode C,while those of malignant lesions were mode B.The lesions with enhancement degree of type 1 are defined as benign lesions,and type 2 and type 3 lesions are defined as malignant lesions.Compared with the results of pathological diagnosis,the accuracy of this method in the diagnosis of benign and malignant breast lesions is 86.7%,the sensitivity is 90.9%,and the specificity is 80.6%.The sensitivity and specificity of single MLO radiography in the diagnosis of benign and malignant lesions were higher than that of conventional radiography.Conclusion CESM quantitative analysis（RS%,SDNR）and enhanced mode analysis can improve the diagnostic specificity of CESM,and increasing single MLO radiography can improve the diagnostic efficiency of CESM.