유방암 환자에 있어서 Breast CT의 유용성과 피폭선량 비교에 관한 고찰

A report about the usefulness of Breast CT and the comparison of permissible radiation exposure level with those who are suffering from breast cancers

Purpose Nowadays the breast cancer is one of the most important cause of female cancer attack rate in Korea due to many reasons of changes of dietary, variations of female hormone, diversities of lactation and so on. To diagnose this disease, mommography and breast sono graphy are universally accepted but additionally breast MRI and breast CT tests are the most prevalent treats recently. First, Breast CT test allows us to figure out accurate lesions using reorganized 3D(three dementional methods) before operations and make a thorough examination for the presence of changes including axial image. Moreover it can be found out shapes of lesion, changes of lymph node and enhancement pattern. Second, it makes cut down shortcomings of previous CT tests because of scanning with minimum radiation exposure level. Subjects and Methods From jan. 2003 to dee. 2004 we designated 55 patients from commitments who were suffering from breast cancers through tests about mammogarphy, breast sono graphy, breast biopsy. With Breast CT test, patients need to take a position with PRO, LPO which contacts with test strips and then put hands up over one’s head. Finally they are injected contrast materials. we have a scan for 90 sec. after infusion of them. And on passing away 300 sec., we also scan in order to identify states that are washed out of blood vessels. Entire amount of contrast materials is 130ml and similar to amounts took use of common CT tests as 3ml per second. Phantoms are used with 4 slice MDCT as a test methods about a permissible radiation exposure level. we measured permissible radiation exposure level in first scanning at 0 o’clock and 8 o’clock and made them calculate in terms of CTDI. Used materials • 4 slice MDCTSomatom Volume Zoom(Siemens Medical Systems, Germany) • Auto injector-Envision CT (Medrad) • Contrast Media- non-ionic contrast. media Ultravist 370(lopromide, Schering) • Workstation-Rapidia(INFINIT) • CT ionization chamber • Radiation dose phantom • Electrometer (reader equipment) Results Lesions(malignant tumor) are 30HU in Pre-CE, 89.7HU IN 90sec-delay, 77.2HU in 300sec-delay in accordance with contrast enhancements and have fixed rate. CTDIDLP levels for such a test are distinguished such as breast CT 297mG, low dose CT 324mGy, chest CT 1206mGy. And breast CT test is the lowest or similar level. Consequences Breast tests which didn’t accepted in the past due to a great deal of dose, have extreme resolving power thanks to a development of MDCT(multi detecter computed tomography) and make resolving power be minimized and reduce test period. It allows us figure out lesions and give a hand while diagnosing additional lesion defections. Malignant tumors are identified through a pattern as contrast enhancements and help operation methods to be varied. In addition, though using reorganized 3D(three dementional methods), sham plans before operation can be available because we are able to see the whole shapes of breast, the appearances of blood supply and place of lymph node in 3D not just one section. As women, their breasts are so sensitive and delicate that we can call them as “women’s pride”. With current medicine, we should take a consideration so that patients can spend their remaining in quality. In order to make a diagnosis, acquiring superior image quality is the important thing the society is confronted with.