Xue Jing, Qu Tianyun, Li Zhigang, Shi Bo, Yang Guang, Rong Xiaocui, Li Yazhou, Lin Guoquan, Ping Yong
Department of Radiology; Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, People's Republic of China.
Department of General Surgery; Botou Hospital, Cangzhou City, Hebei Province, 062150, People's Republic of China.
Int J Womens Health. 2025 Feb 7;17:335-344. doi: 10.2147/IJWH.S501752. eCollection 2025.
To evaluate the association between background parenchymal enhancement (BPE) level and extent on contrast-enhanced mammography (CEM) with age, menopausal status, breast density, and menstrual cycle phase in women. Additionally, to characterize the dynamic changes in BPE during CEM.
This retrospective study included 103 women who underwent CEM at a single institution between September 2019 and November 2021 for screening or diagnostic purposes. Menopausal status and menstrual cycle phase were recorded for all patients. BPE on subtracted CEM images was assessed quantitatively (region of interest [ROI] analysis of pixel values) and qualitatively (subjective classification). Statistical analysis was performed to determine the relationship between BPE (level and extent) and age, menopausal status, breast density, and menstrual cycle phase. Dynamic changes in BPE level over time were also analyzed.
Both BPE level and extent were negatively correlated with age (P=0.004, r=-0.280; P=0.001, r=-0.318). Postmenopausal women exhibited lower BPE level and extent compared to premenopausal women (P=0.003, Z=-2.958; P=0.042, 2=4.123). No significant association was observed between BPE and breast density or menstrual cycle phase (P>0.05). BPE level increased significantly from 3 to 9 minutes post-contrast injection (P<0.001, t=-10.7).
BPE in CEM is significantly associated with age and menopausal status. Further research is needed to clarify the relationship between BPE and breast density and menstrual cycle phase. BPE demonstrates a dynamic increase in level over time, this relates to post-contrast injection, rather than to the age of the woman.
评估对比增强乳腺X线摄影（CEM）中背景实质强化（BPE）水平及范围与女性年龄、绝经状态、乳腺密度和月经周期阶段之间的关联。此外，对CEM期间BPE的动态变化进行特征描述。
这项回顾性研究纳入了2019年9月至2021年11月期间在单一机构接受CEM检查以进行筛查或诊断的103名女性。记录所有患者的绝经状态和月经周期阶段。对减影CEM图像上的BPE进行定量评估（像素值的感兴趣区[ROI]分析）和定性评估（主观分类）。进行统计分析以确定BPE（水平和范围）与年龄、绝经状态、乳腺密度和月经周期阶段之间的关系。还分析了BPE水平随时间的动态变化。
BPE水平和范围均与年龄呈负相关（P = 0.004，r = -0.280；P = 0.001，r = -0.318）。绝经后女性的BPE水平和范围低于绝经前女性（P = 0.003，Z = -2.958；P = 0.042，Z = 4.123）。未观察到BPE与乳腺密度或月经周期阶段之间存在显著关联（P>0.05）。注射对比剂后3至9分钟，BPE水平显著升高（P<0.001，t = -10.7）。
CEM中的BPE与年龄和绝经状态显著相关。需要进一步研究以阐明BPE与乳腺密度和月经周期阶段之间的关系。BPE水平随时间呈动态升高，这与注射对比剂后有关，而非与女性年龄有关。
