对比增强乳房X光检查（CEM）涉及在数字乳房X光检查中添加静脉内碘造影剂，从而通过肿瘤对比增强来提高检测乳腺癌的能力。图像采集后，解释包括仔细评估技术、伪影和陷阱，并使用标准词典类别和适当的后续建议进行报告。应检测可能导致图像误解的伪影和陷阱，并将其与病理状况区分开来。 CEM 图像上明显的不同伪影通常是在图像采集过程中引起的，除了典型的数字乳房 X 线摄影伪影之外，还包括 CEM 特定的伪影和造影剂相关的伪影。这些陷阱与技术和诊断困难有关。 MRI 不具备的 CEM 的一个缺点是与乳房 X 线摄影技术相关的技术因素，该技术因素包含可能不包含在乳房 X 线摄影视图的成像范围内的盲点，包括腋窝、乳房内侧区域或靠近乳房的区域。胸壁。正常乳腺组织增强（称为背景实质增强）也存在于 CEM 中，可能会影响判读性能。诊断陷阱是由微弱强化病变引起的，例如浸润性小叶癌和粘液癌，这些病变很难用 CEM 检测到，从而导致假阴性结果。良性病变可在 CEM 上显示增强，并代表假阳性病变，也应予以识别。作者讨论了 CEM 研究的图像解释，并重点讨论了可能遇到的伪影和陷阱。 ©RSNA，2023 本文的测验问题可在补充材料中找到。

Contrast-enhanced mammography (CEM) involves addition of intravenous iodinated contrast material at digital mammography, thus increasing the ability to detect breast cancer owing to tumor contrast enhancement. After image acquisition, interpretation includes careful assessment of the technique, artifacts, and pitfalls and reporting with a standard lexicon category and appropriate follow-up recommendations. Artifacts and pitfalls that may cause image misinterpretation should be detected and distinguished from pathologic conditions. Different artifacts apparent on CEM images are usually caused during image acquisition and include CEM-specific and contrast agent-related artifacts, apart from the typical digital mammography artifacts. The pitfalls are related to technical and diagnostic difficulties. One disadvantage of CEM that MRI does not have is a technical factor related to a mammography technique that consists of blind spots that may not be included in the imaging field of mammography views, including the axilla, medial region of the breast, or areas close to the breast wall. Normal breast tissue enhancement called background parenchymal enhancement is also present at CEM and may affect interpretation performance. Diagnostic pitfalls are caused by minimally enhancing lesions, such as invasive lobular carcinomas and mucinous carcinomas, which are difficult to detect with CEM, resulting in false-negative findings. Benign lesions can show enhancement at CEM and represent false-positive lesions that should also be recognized. The authors discuss image interpretation of CEM studies and focus on the artifacts and pitfalls that may be encountered. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.