正常妇女月经不同时期乳腺超声影像特点与血清雌、孕激素水平的关系

Features of Breast Ultrasound Image and Its Correlation with Estradiol and Progesterone Level in Different Phases of Menstrual Cycle in Normal Women

目的观察正常妇女不同月经时期的乳腺超声影像特点,分析其与血清雌、孕激素水平的关系。方法50名25～45岁月经正常、未发现乳腺疾患的妇女,记录近3个月经周期中乳腺胀疼出现的时间及持续时间,分别于月经前3～7d(黄体期)和月经周期第9～12天(晚卵泡期)进行乳腺超声检查,测量乳腺腺体层厚度、导管宽度、乳腺腺体结构及血流,并于超声检查当日取血,用磁分离酶免法测血清雌二醇(E2)、孕酮(P)水平。结果黄体期乳腺腺体层较晚卵泡期厚7.3%,而晚卵泡期导管较黄体期宽13%,但二者差异无显著性;24名(48%)有乳腺结构改变;30名(60%)有乳房胀疼,皆于月经前出现,平均持续4d,其中19名(63.3%)有乳腺腺体结构改变;无乳腺胀疼20名中仅5名(25%)有结构改变(χ2,P<0.01)。有、无乳房胀疼者其黄体期血清E2水平分别为365.0pmol/L和335.3pmol/L(P>0.05);P水平分别为73.3nmol/L和66.1nmol/L(P>0.05);晚卵泡期E2水平分别为299.9pmol/L和385.8pmol/L(P=0.05);有、无乳腺结构改变者其黄体期血清E2水平分别为368.1pmol/L和322.7pmol/L(P<0.05),P水平分别为78.8nmol/L和62.2nmol/L(P=0.05);晚卵泡期E2水平分别为301.9pmol/L和364.2pmol/L(P>0.05)。结论乳腺腺体声像图表现随月经周期而变化;乳房胀疼与乳腺腺体结构改变相关;

Objective To determine the features of the breast ultrasound image and its correlation with estro-gen and progestogen level during different phases of menstrual cycle in normal women.Methods Br east ultrasound was performed during luteal phase and late follicular phase in50women aged25～45,with normal menstrual cycle and no distinct breast disease.Breast section thickness,ductal width,breast structure and blood flow were measured.Initial time and persistent days of the cyclic breast pain were recorded.Serum estradiol(E 2 )and progesterone (P)levels were measured by enzyme immunoassay on the day of ultrasound performed.Results Breast glandular section was thicker(increasing by7.3%)in luteal phase than that in late follicular phase and breast ductal was wider(in creasing by13%)in late follicular phase than that in luteal phase.However,both of them had no sign if icant difference.Thirty women(60%)experienced cyclic premenstrual mastalgia,lasting4days.Twenty four women(48%)had breast structure changes,nineteen(63.3%)of30women with cyclic ma stalgia,but only5(25%)of20women without breast pain had breast structure change(χ 2 ,P<0.01). Ave rage serum E 2 level of women with or without cyclic breast pain in luteal phase were365.0pmol/L and335.3pmol/L respectively (P>0.05),serum progesterone level were73.3nmol/L and66.1nmol/L respectively(P>0.05).Serum E 2 levels of women with or without cyclic breast pain in late follicu lar phase were299.9pmol/L and385.8pmol/L respectively (P=0.05).Average serum E 2 levels of women with or without breast structure change in luteal phase were368.1pmol/L and322.7pmol/L respectively(P<0.05).Serum P levels were78.8nmol/L and62.2nmol/L respectively(P=0.05);Estradiol levels in late follicular phase were301.9pmol/L and364.2pmol/L respectively(P>0.05).Conclusions Image of breast ultrasound changed following menstrual cycle in normal menstrual wom en.Breast structure changes is related to breast pain.Breast pain and bre ast structure changes may be caused by higher E 2 and P level in luteal phase and lower E 2 /P ratio in late follicular phase.