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Radiologie up2date 2015; 15(03): 215-234
DOI: 10.1055/s-0034-1393053
Brustbildgebung/Mammografie
© Georg Thieme Verlag KG Stuttgart · New York

Digitale Mammografie und ihre Weiterentwicklungen

Digital mammography and their developments
S. Wienbeck
,
U. Fischer
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Publication History

Publication Date:
11 September 2015 (online)

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Zusammenfassung

In definierten Altersgruppen ist die Mammografie sowohl in der Klinik als auch beim Screening ein akzeptables Verfahren. Ihre Einschränkungen liegen – außer der Strahlenbelastung – im Nachweis nicht kalzifizierter Karzinome bei Frauen mit hoher Dichte des Drüsengewebes. Die Tomosynthese, die digitale Kontrastmittelmammografie und die Brust-CT (mit oder ohne Kontrastmittel) führen zu besseren Ergebnissen. Insbesondere die Applikation von Kontrastmittel zur Darstellung der Tumorangiogenese ist allen anderen bildgebenden Verfahren ohne Kontrastmittel überlegen. Trotzdem werden die ausgezeichneten Ergebnisse der Brust-MRT wahrscheinlich mit keinem dieser Verfahren zu erreichen sein.

Abstract

At the present time digital mammography is a satisfactory breast diagnostic imaging in clinical as well as screening mammography in defined age groups. Nevertheless it shows beside the application of ionizing radiation in women with dense breasts limitations in the detection of non calcification breast cancers. Tomosynthesis, digital contrast-enhanced mammography and breast-CT with or without contrast media lead to better results. Especially the application of contrast media for the visualisation of the tumor angiogenesis is invariably superior to all other non-contrast imaging modalities. However, the excellent results of breast MRI will be probably accessible with none of the new procedures.

Kernaussagen

  • Zum gegenwärtigen Zeitpunkt muss die Mammografie in der Früherkennung und grundlegenden präventiven Versorgung der weiblichen Bevölkerung in definierten Altersklassen als ein akzeptables Verfahren angesehen werden. Allerdings weist es neben dem Einsatz ionisierender Strahlung insbesondere bei dichten Brüsten drastische Limitationen in der Detektion nicht kalzifizierter Karzinome auf.

  • Tomosynthese, Kontrastmittel-Spektralmammografie und Brust-CT bzw. Kontrastmittel-Brust-CT führen hier zu besseren Ergebnissen, wobei insbesondere der Einsatz von Kontrastmitteln zur Visualisierung der Tumorangiogenese den entscheidenden Vorteil gegenüber allen nicht kontrastmittelgestützten mammografischen Verfahren bringt.

  • Die exzellenten Ergebnisse einer qualitativ hochwertigen Mamma-MRT werden allerdings wohl mit keinem der neuen Verfahren erreichbar sein.

Keywords

Breast - digital mammography - tomosynthesis - contrast enhanced mammography - breast-CT - contrast-enhanced breast CT
 

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