月经周期对正常乳腺不同部位扩散张量成像各向异性分数的影响

Influence of menstrucal cycle and anatomic site on fractional anisotropy of diffusion tensor imaging in normal breast

目的探讨月经周期及解剖部位对正常乳腺扩散张量成像（DTI）各向异性指数（FA）值的影响。方法前瞻性收集月经周期正常，行乳腺体检、超声或MRI平扫未发现乳腺疾病的志愿者96名，根据月经周期将受试者为月经期（月经来潮第1～6天）、增殖期（月经来潮第7～14天）和分泌期（月经来潮第15天至下次月经期前）组，其中月经期、增殖期、分泌期各32名。所有受试者均行双侧乳腺横断面T1WI、T2WI、DWI和DTI检查。在乳头层面FA图上，将乳腺分为前、中、后部3个部位，测量不同月经周期和不同部位乳腺的FA值。采用Kruskal-WallisH秩和检验比较不同部位间及不同月经周期间乳腺FA值的差异。结果月经期、增殖期、分泌期女性前部乳腺的FA值分别为0．21±0．07、0．24±0．09和0．17±0．07，差异有统计学意义（P=0．014）；中部FA值分别为0．15±0．08、0．18±0．09和0．15±0．07，差异无统计学意义（P=0．090）；后部FA值分别为0．21±0．11、0．24±0．13和0．16±0．11，差异有统计学意义（P=0．002）。不同部位间比较，月经期和增殖期FA值的差异有统计学意义（P值分别为0．018和0．045）。同一区域的FA值在分泌期最低，增殖期略高于月经期。结论乳腺FA值受月经周期及解剖部位的影响。

Objective To investigate the influence of menstrucal cycle and anatomic site on the fractional anisotropy （FA） values of diffusion tensor imaging （DTI） in normal breast. Methods Prospectively enrolled 96 volunteers, who have identified with normal menstrucal phase and without breast diseases were found via the breast examination, ultrasound and MRI scan. The cases were divided into three groups according to menstrucal phase： menstrual period group （menstrual cramps 1 to 6 d）, proliferative phase group（menstrual cramps 7 to 14 d） and secretory phase group（menstrual cramps 15 d to the next）, and each group consisted of 32 subjects. All subjects were performed bilateral breast cross-sectional T1WI, T2WI, DWI and DTI scaning. On the nipple level figture, the mammary gland was divided into three regions including the anterior, central and posterior parts, and the FA values of the different phases and regions were measured. The Kruskal-Wallis H test was applied to analyse the difference of FA values in different menstrual phase and anatomic site. Results The FA values of the anterior region in menstrual phase, proliferative phase and secretary phase were 0.21±0.07, 0.24±0.09 and 0.17±0.07, and the difference had significant difference（P=0.014）.The FA values of the central region were respectively 0.15±0.08, 0.18±0.09 and 0.15±0.07, and without the statistically significant difference（P=0.090）. The FA values of the posterior region were 0.21±0.11, 0.24±0.13 and 0.16±0.11, and also showed significant difference （P=0.002）. In different regions, the difference of FA values between menstrual phases and proliferative phases were also had statistically significant （P=0.018, 0.045, respectively）. In the same region, the FA value was lowest in the secretary phase, and the proliferative phase was slightly higher than menstrual phase. Conclusion The FA values are affected by menstrual cycle and anatomic site.