年龄、月经状态对乳腺磁共振体素内不相干运动成像的影响

Influence of age and menstrual statuses on breast intravoxel incoherent motion imaging

目的探讨正常乳腺组织在不同月经状态和不同年龄段磁共振体素内不相干运动(IVIM)成像各参数值变化情况。方法共有375例女性受试者纳入研究,其中绝经前302例,绝经后73例。根据年龄高低,将绝经前受试者分为低、中、高三个年龄组,并根据月经周期不同阶段将每个年龄组受试者分为五个亚组(月经期、增殖期、卵泡期、黄体期、分泌期)。采用10个b值(0、10、20、50、100、200、300、400、600、800 s/mm2)的IVIM成像方法,对所有受试者进行乳腺磁共振IVIM检查,基于感兴趣区(ROI),测量正常乳腺组织的真实弥散系数(D)、灌注相关弥散系数(D*)和血管容积分数(f)。使用单因素方差分析受试者月经周期不同阶段以及绝经前后IVIM各参数值的差异。结果绝经后受试者正常乳腺组织D值和D*值较绝经前受试者明显下降。绝经前正常乳腺组织D值(低、中、高年龄组)和D*值(低、中年龄组)随月经周期各阶段呈现有规律的波动:黄体期或卵泡期数值较高,而其他各期数值相对较低。卵泡期与黄体期D值和D*值由高到低排列为:低年龄组、中年龄组、高年龄组。分泌期D值由高到低排列为:低年龄组、中年龄组、高年龄组。结论磁共振IVIM成像可以定量反映月经状态对于正常乳腺组织的影响。在使用IVIM诊断乳腺病变时应该充分认识到月经状态以及年龄因素对IVIM各参数值的影响。

ObjectiveThe aim of the study was to characterize the variability of magnetic resonance imaging intravoxel incoherent motion （MRI-IVIM） values in normal breast tissue at different status of menstruation and different ages.Methods This study included a total of 375 female subjects with 302 premenopausal subjects and 73 postmenopausal subjects. The premenopausal subjects were divided into three age groups （low, median and high groups） and each group were divided into five subgroups （menstrual, proliferative, follicular, luteal and secretory subgroups） according to menstrual cycles and menopausal status. The IVIM values of D, D＊ and f were acquired on normal breast tissue in all these 375 subjects based on region of interest （ROI）.ResultsThe D and D＊ values of the postmenopausal breast tissue were obviously lower than that of the premenopausal breast tissue. For premenopausal breast tissue, the D values of low, median and high age groups and the D＊ values of low and median age groups showed regular fluctuations： higher values in luteal phase or follicular phase, lower values in other phases. The D values and D＊ values in luteal phase and follicular phase were the following from higher to lower values： low, median and high age groups. The D values in secretory phase were the following from higher to lower values： low, median and high age groups.ConclusionMRI-IVIMcan quantitatively represent the influence of different menstrual status on normal breast tissue. The variability of IVIM values in normal breast tissue at different phases of menstrual cycle and menopausal status should be noted when IVIM is used as a tool in diagnosing breast lesions.