CAR乳腺影像与介入实践指南:对比增强乳腺摄影
加拿大放射科医师协会(CAR)发布乳腺影像与介入实践指南第二部分,聚焦对比增强乳腺摄影(CEM)的临床应用。指南基于2016年以来不断扩大的证据基础和临床普及,更新了CEM的适应证、检查技术、对比剂使用、图像解读、报告标准、质量控制和患者安全等方面的推荐。特别强调CEM在诊断性问题解决、术前分期以及乳腺MRI不可用或禁忌时的特定筛查场景中的作用。
要点
- CEM适用于诊断性问题解决、术前分期及MRI不可用/禁忌时的筛查场景。
- 指南涵盖CEM适应证、技术、对比剂、图像解读、报告标准、质控和患者安全。
- CEM应用需结合临床判断,并考虑技术进展、区域资源和患者个体因素。
诊断标准与关键数值
- 指南推荐CEM用于诊断性问题解决、术前分期及乳腺MRI不可用或禁忌时的特定筛查场景。
临床应用与阅片要点
- 日常阅片可将CEM用于诊断问题解决和术前分期,尤其在MRI不可用或禁忌时。
- 报告应遵循指南更新的报告标准,并注意结合临床判断和患者个体因素。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
英文原文(摘要)· 点击展开
This guideline presents Part II of the Canadian Association of Radiologists (CAR) Practice Guidelines on Breast Imaging and Intervention and addresses the clinical application of contrast-enhanced mammography (CEM). Reflecting the expanding evidence base and increasing clinical adoption of CEM since 2016, this guideline provides updated recommendations on indications, examination technique, contrast administration, image interpretation, reporting standards, quality control, and patient safety. Particular emphasis is placed on the role of CEM in diagnostic problem-solving, preoperative staging, and selected screening scenarios when breast MRI is unavailable or contraindicated. This guideline is intended to be used in conjunction with the other 4 components of the CAR Breast Practice Guidelines series, which together replace the previous consolidated guidelines and align with national and international best practices. While establishing minimum standards and best practices, this guideline recognizes the influence of evolving technology, regional resources, and patient-specific considerations, and affirms that clinical judgment remains the responsibility of the supervising radiologist.
引用
- Crivellaro PS, Fienberg S, Flegg C, et al. CAR Practice Guidelines on Breast Imaging and Interventions: Contrast-Enhanced Mammography. Can Assoc Radiol J. 2026. PMID: 42198829. doi:10.1177/08465371261451253
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。