绝经后女性的激素替代疗法：通过磁共振成像测定乳腺组织灌注——初步观察
Hormone replacement therapy in postmenopausal women: breast tissue perfusion determined with MR imaging--initial observations.
作者信息
Delille Jean-Paul, Slanetz Priscilla J, Yeh Eren D, Kopans Daniel B, Halpern Elkan F, Garrido Leoncio
机构信息
Division of Breast Imaging and NMR Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
出版信息
Radiology. 2005 Apr;235(1):36-41. doi: 10.1148/radiol.2351040012.
PURPOSE
To use magnetic resonance (MR) imaging to evaluate tissue perfusion in the normal breast parenchyma of postmenopausal women with current or recent hormone replacement therapy (HRT).
MATERIALS AND METHODS
The study was approved by the institutional subcommittee on human studies, and informed consent was obtained from all patients prior to MR imaging. Sixty postmenopausal women (age range, 44-77 years) were grouped according to HRT received: estrogen replacement therapy (ERT) (n = 13), combined (estrogen and progesterone) replacement therapy (CRT) (n = 16), selective estrogen receptor modulator (SERM) therapy (n = 8), and no (hormone replacement) therapy (NT) (n = 23). MR imaging with a 1.5-T magnet was performed by using gradient-echo and dynamic contrast material-enhanced echo-planar pulse sequences before and after gadopentetate dimeglumine injection. Precontrast T1 relaxation times were measured, after which extraction-flow product (EFP) maps were calculated with a multicompartmental model. Analysis of variance was performed.
RESULTS
Age did not significantly differ between the groups (P > .3). Women receiving ERT or CRT at the time of MR imaging had higher EFP values (7.3 mL . 100 g(-1) . min(-1)+/- 2.6 and 7.1 mL . 100 g(-1) . min(-1)+/- 3.8, respectively) than did women receiving NT (4.4 mL . 100 g(-1) . min(-1)+/- 2.1) (P = .012 and P = .008, respectively) or SERM therapy (3.9 mL . 100 g(-1) . min(-1)+/- 1.1) (P = .015 and P = .013, respectively). Women who ended ERT or CRT 1-47 months before MR examination had lower EFP values than did women with current ERT or CRT and had higher EFP values than did women receiving NT or SERM therapy (6.2 mL . 100 g(-1) . min(-1)+/- 2.4 and 5.9 mL . 100 g(-1) . min(-1)+/- 3.8, respectively), but the observed differences were not significant (P > .1). Differences in T1 between all groups were not significant (P > .5).
CONCLUSION
Higher breast tissue perfusion is observed in postmenopausal women receiving HRT.
目的
利用磁共振成像评估接受当前或近期激素替代疗法（HRT）的绝经后女性正常乳腺实质的组织灌注情况。
材料与方法
本研究经机构人体研究小组委员会批准，所有患者在进行磁共振成像检查前均签署了知情同意书。60名绝经后女性（年龄范围44 - 77岁）根据接受的激素替代疗法分组：雌激素替代疗法（ERT）（n = 13）、联合（雌激素和孕激素）替代疗法（CRT）（n = 16）、选择性雌激素受体调节剂（SERM）疗法（n = 8）以及未接受（激素替代）疗法（NT）（n = 23）。使用1.5-T磁共振仪，在注射钆喷酸葡胺前后分别采用梯度回波和动态对比剂增强回波平面脉冲序列进行磁共振成像。测量对比前的T1弛豫时间，然后用多房室模型计算提取流量乘积（EFP）图。进行方差分析。
结果
各组之间年龄差异无统计学意义（P > 0.3）。在进行磁共振成像检查时接受ERT或CRT的女性，其EFP值（分别为7.3 mL·100 g⁻¹·min⁻¹±2.6和7.1 mL·100 g⁻¹·min⁻¹±3.8）高于接受NT治疗的女性（4.4 mL·100 g⁻¹·min⁻¹±2.1）（分别为P = 0.012和P = 0.008）以及接受SERM疗法的女性（3.9 mL·100 g⁻¹·min⁻¹±1.1）（分别为P = 0.015和P = 0.013）。在磁共振检查前1 - 47个月停止ERT或CRT的女性，其EFP值低于正在接受ERT或CRT的女性，但高于接受NT或SERM疗法的女性（分别为6.2 mL·100 g⁻¹·min⁻¹±2.4和5.9 mL·100 g⁻¹·min⁻¹±3.8），但观察到的差异无统计学意义（P > 0.1）。所有组之间的T1差异无统计学意义（P > 0.5）。
结论
接受HRT的绝经后女性乳腺组织灌注较高。
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