Noorily Ariella R, Heller Samantha L, Regen-Tuero Helaina C, Li Xiaochun, Goldberg Judith D, Gao Yiming
Department of Radiology, NYU Langone Health, 660 First Ave, New York, NY 10016.
Department of Population Health, Division of Biostatistics, NYU Grossman School of Medicine, New York, NY.
AJR Am J Roentgenol. 2025 Jul;225(1):e2432624. doi: 10.2214/AJR.24.32624. Epub 2025 May 23.
. Ultrafast MRI (UFMRI) can minimize background parenchymal enhancement (BPE), improve cancer visualization, and inform characterization of malignancy. Although BPE is a biomarker for breast cancer risk, wash-in characteristics of BPE are unknown. . The purpose of this study was to delineate on UFMRI the wash-in behavior of normal BPE in healthy women and to determine associations with patient characteristics. . This retrospective study evaluated consecutive normal screening breast MRI examinations (BI-RADS category 1) from January 2020 to May 2022 with 1 year of negative follow-up MRI. Characteristics including patient age, menopausal status, and risk factors for cancer were recorded. Fibroglandular tissue and BPE on conventional postcontrast sequences were documented. Ultrafast MR images were analyzed for level, time to enhancement (TTE), and maximum slope (MS) of BPE as indicators of wash-in characteristics. Ordinal logistic regression analyses were conducted using a significance level of .05 (two-sided alpha value). . The final sample included 222 women (median age, 50 years; range, 25-81 years), 110 (49.5%) of whom were premenopausal and 112 (50.5%) of whom were postmenopausal. BPE was lower on UFMRI than on conventional MRI in 98.5% of examinations with moderate or marked BPE and in 85.4% of examinations with mild to marked BPE on conventional postcontrast images ( < .001). BPE on UFMRI was marked in 0% and moderate in 4.1% of examinations. BPE was significantly associated with menopausal status, inversely related to age, and significantly associated with TTE. The odds of high BPE on UFMRI were 7.815 times greater in premenopausal women (95% CI, 4.461-13.689; < .001), 1.067 times less per 1-year increase in age (95% CI, 1.046-10.890; < .001), and 1.113 times greater per 1-second decrease in TTE (95% CI, 1.054-1.213; < .001). MS was higher in premenopausal women but was not statistically significant. BPE was not associated with risk factors for cancer. . UFMRI mitigates BPE, essentially eliminating marked and moderate BPE. TTE varies by age and menopausal status, suggesting hormonal underpinning. . Minimizing BPE on UFMRI could improve diagnostic accuracy. Wash-in kinetic parameters of BPE have the potential to serve as biomarkers in breast cancer risk prediction.
超快磁共振成像（UFMRI）可将背景实质强化（BPE）降至最低，改善癌症可视化，并有助于恶性肿瘤的特征描述。尽管BPE是乳腺癌风险的生物标志物，但其流入特征尚不清楚。本研究旨在通过UFMRI描绘健康女性正常BPE的流入行为，并确定其与患者特征的关联。这项回顾性研究评估了2020年1月至2022年5月连续进行的正常乳腺筛查磁共振成像检查（BI-RADS 1类），并进行了1年的阴性随访磁共振成像。记录了患者年龄、绝经状态和癌症风险因素等特征。记录了传统增强后序列上的纤维腺体组织和BPE。分析超快磁共振图像上BPE的水平、强化时间（TTE）和最大斜率（MS），作为流入特征的指标。采用显著性水平为0.05（双侧α值）进行有序逻辑回归分析。最终样本包括222名女性（中位年龄50岁；范围25-81岁），其中110名（49.5%）为绝经前女性，112名（50.5%）为绝经后女性。在98.5%的中度或明显BPE检查以及85.4%的传统增强后图像上轻度至明显BPE检查中，UFMRI上的BPE低于传统磁共振成像（P<0.001）。UFMRI上的BPE在0%的检查中为明显，在4.1%的检查中为中度。BPE与绝经状态显著相关，与年龄呈负相关，与TTE显著相关。绝经前女性UFMRI上高BPE的几率高7.815倍（95%CI，4.461-13.689；P<0.001），年龄每增加1岁几率低1.067倍（95%CI，1.046-10.890；P<0.001），TTE每减少1秒几率高1.113倍（95%CI，1.054-1.213；P<0.001）。绝经前女性的MS较高，但无统计学意义。BPE与癌症风险因素无关。UFMRI可减轻BPE，基本消除明显和中度BPE。TTE因年龄和绝经状态而异，提示有激素基础。在UFMRI上使BPE最小化可提高诊断准确性。BPE的流入动力学参数有可能作为乳腺癌风险预测的生物标志物。
