medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1281medvis-1281Research ArticleМОЛОЧНАЯ ЖЕЛЕЗАBREASTРоль контрастной двухэнергетической спектральной маммографии в диагностике рака молочной железыRole of Contrast-Enhanced Spectral Mammography in the detection of breast cancerhttps://orcid.org/0000-0001-7925-5935АндроновА. К.AndronovA. K.

Андронов Артем Константинович – заведующий отделением диагностики и лечения заболеваний молочной железы и репродуктивной системы №3 

111123 Москва, шоссе Энтузиастов, д. 86

Artem K. Andronov – Head of the department of diagnosis and treatment of breast and reproductive system diseases number 3 

86, Sh. Entuziastov, Moscow 111123

a.andronov@mknc.ruhttps://orcid.org/0000-0002-2893-8274АбдураимовА. Б.AbduraimovA. B.

Абдураимов Адхамжон Бахтиерович – доктор мед. наук, профессор, заместитель директора по образовательной деятельности, руководитель филиала 

111123 Москва, шоссе Энтузиастов, д. 86

Adhamzhon B. Abduraimov – Doct. of Sci. (Med.), Professor, Deputy Director for Educational Activities, Head 

86, Sh. Entuziastov, Moscow 111123

a.abduraimov@mknc.ruГБУЗ “Московский клинический научный центр им. А.С. Логинова” ДЗ города Москвы, Филиал “Маммологический центр (Клиника женского здоровья)”РоссияBranch “Mammology center (Women’s Health Clinic)”, Moscow Clinical Scientific Center named after A.S. LoginovRussian Federation2023310720232748191Copyright © Андронов А.К., Абдураимов А.Б., 20232023Андронов А.К., Абдураимов А.Б.Andronov A.K., Abduraimov A.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1281

Цель исследования: оценить преимущества использования контрастной двухэнергетической спектральной маммографии (Contrast-Enhansed Spectral Mammography (CESM)) у пациенток с установленной категорией BI-RADS 4a, 4b по результатам стандартного обследования (цифровая маммография и УЗИ молочных желез). Материал и методы. Проанализированы данные 425 пациенток с подозрительной категорией BI-RADS в период с 2018 по 2021 г. В рамках дообследования всем пациенткам выполнена CESM с последующей гистологической верификацией выявленных изменений. Оценены чувствительность и специфичность выполненных методов исследования. Результаты. Окончательный диагноз рака молочной железы был установлен у 247 (58,1%) из 425 женщин. У 17 (6,8%) пациенток из 247 был диагностирован мультицентрический и мультифокальный рост, а первично-множественный синхронный рак выявлен у 6 (2,4%) пациенток из 247. Ложноположительные случаи при оценке CESM преимущественно составили типичная и атипическая протоковая гиперплазия, фиброаденома, внутрипротоковая папиллома. Заключение. Контрастная двухэнергетическая спектральная маммография является высокочувствительным и высокоспецифичным методом в выявлении злокачественных образований молочной железы. Метод позволяет минимизировать количество нежелательных интервенционных вмешательств в молочной железе при подозрительных категориях BI-RADS. 

Objective: to assess the benefits of using contrast-enhancer spectral mammography in patients with an established category of BI-RADS 4a, 4b according to the results of a standard examination (digital mammography and ultrasound). Materials and methods. The date of 425 patients with a suspicious category of BI-RADS in the period from 2018 to 2021 were analyzed. As part of the additional examination, all patients underwent contrast-enhanced spectral mammography follow by histological verification of the identified changes. The sensitivity and specificity of the methods were evaluated. Results. The final diagnosis of breast cancer was established in 247 (58.1%) patients out of 425 women. Multicenter and multifocal growth was diagnosed in 17 (6.8%) patients out of 247, and primary multiple synchronous cancer was detected in 6 (2.4%) patients out of 247. False-positive cases when assessing CESM mainly consisted of: typical and atypical ductal hyperplasia, fibroadenoma, intraductal papilloma. Conclusion. Contrast-enhancer spectral mammography is a highly sensitive and highly specific method in the detection of malignant tumors of the breast. The method also allows minimizing the number of unwanted interventions in suspicious BI-RADS categories.

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The authors declare that there are no conflicts of interest present.