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目的评价女性月经状态及月经周期对乳腺MR动态增强检查中不同时相的纤维腺体背景强化(BPE)的影响。方法搜集2013年5月至2014年2月期间行乳腺MR增强检查且月经情况明确的女性279例,共分析动态增强后第1 min、2 min和8 min三个时相(Phase1、2、8)的BPE。定性分析根据2013年美国放射学院(ACR)提出的乳腺影像报告和数据系统(BI-RADS)标准,将BPE分为4型:轻微强化、轻度强化、中度强化和显著强化;通过计算动态增强后乳腺BPE信号强度(SI)增加的百分率[(SI_E-SI_P)/SI_P×100%]来定量分析BPE。应用MannWhitney U检验和Kruskal-Wzllis H检验比较不同月经状态和月经周期下乳腺BPE程度。结果绝经前女性动态增强后第1、2、8时相乳腺BPE均高于绝经后女性,差异均有统计学意义(P<0.001)。在189例绝经前女性中,月经各周期乳腺BPE之间差异无统计学意义(P>0.05),但月经周期第2周乳腺BPE低于第1、3、4周。结论月经状态及月经周期不同,激素水平呈现不同水平和周期性变化,均对乳腺BPE有一定影响。绝经前女性乳腺BPE显著高于绝经后女性,月经周期第2周乳腺BPE最低,在月经周期第3、4周呈现上升趋势。
Objective To evaluate the effect of female menstrual status and menstrual cycle on fibroadeno-gland background enhancement (BPE) at different phases in MR dynamic enhancement of breast. Methods A total of 279 women who underwent MR enhanced MR examination during the period from May 2013 to February 2014 were enrolled in this study. Three phases of 1, 2 and 8 min after dynamic enhancement were analyzed (Phase1, 2 and 8 ) Of BPE. Qualitative Analysis Based on the Breast Imaging Reporting and Data System for Breast Imaging (BI-RADS) standard presented by the American College of Radiology (ACR) in 2013, BPE was categorized as Type 4: slightly enhanced, mildly enhanced, moderately enhanced, and significantly enhanced; BPE was quantified by increasing the percentage of post-breast BPE signal intensity (SI) [(SI_E-SI_P) / SI_P × 100%]. MannWhitney U test and Kruskal-Wzllis H test were used to compare breast BPE levels under different menstrual cycles and menses. Results The BPE of mammary gland in the first, second and eighth phases of postmenopausal women was significantly higher than that of the postmenopausal women (P <0.001). In 189 premenopausal women, there was no significant difference in breast BPE between the menstrual cycles (P> 0.05), but the BPE of the breast in the second week of the menstrual cycle was lower than that of the 1st, 3rd, 4th week. Conclusions The menstrual status and menstrual cycle are different, and the hormones show different levels and periodic changes, all of which have a certain impact on the BPE of the breast. Premenopausal women breast BPE was significantly higher than postmenopausal women, the second week of the menstrual cycle, breast BPE lowest in the first three weeks of the menstrual cycle showed an upward trend.