Department of Diagnostic Radiology and Neuroradiology, Ernst-Moritz-Arndt University Medical Center Greifswald, Ferdinand-Sauerbruch-Strasse 1, 17475, Greifswald, Germany.
Eur Radiol. 2012 Dec;22(12):2633-40. doi: 10.1007/s00330-012-2544-9. Epub 2012 Jul 8.
To investigate effects of menopausal status, oral contraceptives (OC), and postmenopausal hormone therapy (HT) on normal breast parenchymal contrast enhancement (CE) and non-mass-like enhancing areas in magnetic resonance mammography (MRM).
A total of 459 female volunteers (mean age 49.1 ± 12.5 years) underwent T1-weighted 3D MRM 1-5 min after bolus injection of gadobutrol. Quantitative analysis was performed in normal breast parenchyma by manually tracing regions of interest and calculating percentage CE. Semiquantitative analysis was performed in non-mass-like enhancing areas, and signal intensity changes were characterised by five predefined kinetic curve types. The influence of OC (n = 69) and HT (n = 24) on CE was studied using random effects models.
Breast parenchymal enhancement was significantly higher in premenopausal than in postmenopausal women (P < 0.001). CE decreased significantly with the use of OC (P = 0.01), while HT had negligible effects (P = 0.52). Prevalence of kinetic curve types of non-mass-like enhancement differed strongly between pre- and postmenopausal women (P < 0.0001), but was similar in OC users and non-OC users (P = 0.61) as well as HT users and non-HT users (P = 0.77).
Normal breast parenchymal enhancement and non-mass-like enhancing areas were strongly affected by menopausal status, while they were not affected by HT use and only moderately by OC use.
Breast parenchymal enhancement at MR mammography is stronger in premenopausal than postmenopausal women. The prevalence of strong enhancing non-mass-like areas is greater before menopause. Such enhancing non-mass-like areas may impair lesion detection in premenopausal women. Breast parenchymal enhancement is only marginally affected by hormone use. Discontinuation of hormone use before MR mammography may be unnecessary.
探讨绝经状态、口服避孕药（OC）和绝经后激素治疗（HT）对磁共振乳腺成像（MRM）中正常乳腺实质对比增强（CE）和非肿块样增强区域的影响。
共 459 名女性志愿者（平均年龄 49.1±12.5 岁）在注射钆布醇后 1-5 分钟内行 T1 加权 3D MRM。通过手动绘制感兴趣区并计算 CE 百分比对正常乳腺实质进行定量分析。对非肿块样增强区域进行半定量分析，通过五种预设的动力学曲线类型来描述信号强度变化。使用随机效应模型研究 OC（n=69）和 HT（n=24）对 CE 的影响。
绝经前女性的乳腺实质增强明显高于绝经后女性（P＜0.001）。OC 的使用显著降低了 CE（P=0.01），而 HT 的影响可忽略不计（P=0.52）。非肿块样增强的动力学曲线类型在绝经前和绝经后女性之间差异显著（P＜0.0001），但在 OC 使用者和非 OC 使用者（P=0.61）以及 HT 使用者和非 HT 使用者（P=0.77）之间相似。
正常乳腺实质增强和非肿块样增强区域受绝经状态影响显著，而不受 HT 应用影响，仅受 OC 应用中度影响。
MR 乳腺成像中，绝经前女性的乳腺实质增强强于绝经后女性。绝经前强增强的非肿块样区域的发生率更高。这些增强的非肿块样区域可能会影响绝经前女性的病变检测。乳腺实质增强仅受激素使用的轻微影响。在进行 MR 乳腺成像前停止激素使用可能是不必要的。
