Okuma Hidemi, Masarwah Amro, Istomin Aleksandr, Nykänen Aki, Hakumäki Juhana, Vanninen Ritva, Sudah Mazen
Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, P.O. Box 1627, Kuopio Fl 70211, Finland.
Department of Clinical Radiology, Diagnostic Imaging Center, Kuopio University Hospital, P.O. Box 100, Kuopio Fl 70029, Finland.
Eur J Radiol Open. 2024 Nov 18;13:100611. doi: 10.1016/j.ejro.2024.100611. eCollection 2024 Dec.
To examine the background parenchymal enhancement (BPE) levels in peri-menopausal breast MRI compared with pre- and post-menopausal breast MRI.
This study included 562 patients (55.8±12.3 years) who underwent contrast-enhanced dynamic breast MRI between 2011 and 2015 for clinical indications. We evaluated the BPE level, amount of fibroglandular tissue (FGT), and social and clinical variables. The inter-reader agreement for the amount of FGT and the BPE level was evaluated using interclass correlation coefficients. Associations between the BPE level and body mass index (BMI), ages of menarche and menopause, childbirth history, number of children, and the amount of FGT were determined using Spearman's correlation coefficients or Mann-Whitney -test. Pearson's χ test was used to assess the difference in the frequency of BPE categories among the age-groups.
The inter-reader agreement was 0.864 for the amount of FGT and 0.840 for the BPE level, both indicating almost perfect agreement. The BPE level showed a weak positive correlation with the amount of FGT (Spearman's ρ=0.271, <0.001). BPE was not significantly correlated with BMI, childbirth history, number of births, or ages of menarche or menopause. BPE was greater in the peri-menopausal age-group compared with the corresponding pre- and post-menopausal age-groups, both with benign and malignant lesions.
BPE was greater in the peri-menopausal stage than in the pre- and post-menopausal stages. Our results suggest that BPE showed a non-linear decrease with age and that the hormonal disbalance in the peri-menopausal period has a greater effect on the BPE level than was previously assumed.
比较围绝经期乳腺MRI与绝经前和绝经后乳腺MRI的背景实质强化（BPE）水平。
本研究纳入了562例患者（年龄55.8±12.3岁），这些患者在2011年至2015年间因临床指征接受了对比增强动态乳腺MRI检查。我们评估了BPE水平、纤维腺体组织（FGT）量以及社会和临床变量。使用组内相关系数评估阅片者之间关于FGT量和BPE水平的一致性。使用Spearman相关系数或Mann-Whitney检验确定BPE水平与体重指数（BMI）、初潮年龄和绝经年龄、分娩史、子女数以及FGT量之间的关联。使用Pearson卡方检验评估各年龄组中BPE类别频率的差异。
阅片者之间关于FGT量的一致性为0.864，关于BPE水平的一致性为0.840，两者均表明几乎完全一致。BPE水平与FGT量呈弱正相关（Spearman ρ=0.271，P<0.001）。BPE与BMI、分娩史、生育次数、初潮年龄或绝经年龄均无显著相关性。在围绝经期年龄组中，无论良性还是恶性病变，BPE均高于相应的绝经前和绝经后年龄组。
围绝经期的BPE高于绝经前和绝经后阶段。我们的结果表明，BPE随年龄呈非线性下降，且围绝经期的激素失衡对BPE水平的影响比之前认为的更大。
