多参数MRI评价年轻女性正常乳腺组织随月经周期变化规律的研究  

The Research of Multi-parameter MRI Evaluation of Young Women with Normal Breast Tissues Changes during the Menstrual Cycle

作　　者：樊秋菊 谭辉[1,2] 杨褀 于楠[1,2] 王少彧 FAN Qiuju;TAN Hui;YANG Qi(Department of Radiology,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang,Shaanxi Province 712000,P.R.China)

机构地区：[1]陕西中医药大学附属医院影像科,咸阳712000 [2]陕西中医药大学基础医学与医学技术学院,咸阳 [3]西门子医疗系统有限公司磁共振事业部,上海

出　　处：《临床放射学杂志》2018年第8期1283-1287,共5页Journal of Clinical Radiology

摘　　要：目的探讨育龄期正常乳腺组织在不同月经周期下磁共振体素内不相干运动（IVIM）、扩散张量成像（DTI）及扩散加权成像（DWI）各参数值变化情况。方法共搜集26名健康女性志愿者,年龄22~30岁,平均26岁,规律月经周期,无口服避孕药史,未育。分别在月经期（第2天）、增生期（第7天）、卵泡期（第14天）、黄体期（第21天）、分泌期（第27天）进行了1个月经周期的MRI扫描,扫描序列包括T1WI、T2WI、DTI、DWI及IVIM。基于感兴趣区（ROI）的方法,由2名观察者分别在不同时间测量相同区域正常乳腺组织的真实扩散系数（D）、灌注相关扩散系数（D^＊）、血管容积分数（f）、各向异性分数（FA）及表观扩散系数（ADC）。结果采用3.0 T MR获得的IVIM、DTI、DWI乳腺图像具有较高的图像质量和分辨率,其参数图无严重伪影,图像质量较好,能满足参数测量要求。2名观察者分别所测得（观察者间）D值、D^＊值、FA值及ADC值可重复性好（ICC值〉0.8）,f值可重复性较差。正常乳腺的D^＊值显示随月经周期规律波动,在黄体期最高,与月经期和增殖期对比,有显著性差异（P〈0.01）;f值在卵泡期高于其他阶段,但是对比没有显著差异。D值和ADC值随月经周期有相似趋势,D值在黄体期和增殖期对比,差异具有统计学意义（P=0.005）;ADC值的差异在月经周期中无统计学意义。FA值在月经期与分泌期对比差异有统计学意义（P=0.034）。结论乳腺D值、D^＊值、FA值及ADC值可重复性好,可以敏感地反映乳腺组织随月经周期激素调节的变化特点。Objective Our goal was to investigate the parameters obtained with IVIM、DTI and DWI imaging of the breast throughout the menstrual cycle phases in young volunteers. Methods The study included 26 healthy female volunteers （median age,26 years; age range,22-30 years）,with a regular menstrual cycle,none of the volunteers were taking oral contraceptives,and all were nulliparous. These volunteers underwent imaging five times during one menstrual cycle： （menstrual,proliferative,follicular,luteal and secretory）. The imaging included axial T2-weighted images. Axial DTI 、IVIM 、DWI sequences. Results 1. IVIM,DTI and DWI breast images obtained by 3. 0 t MRI have higher image quality and resolution,with no serious image artifacts of the parameters,which can satisfy the parameter measurement requirements.2. The value of D,D^＊,FA and ADC measured by two different observers show good repeatability （ICC value 0. 8）. The f value shows poor repeatability. 3. The value of D^＊,D,FA,and ADC varied during menstrual cycle except f value. The changes of D value and ADC value presented a similar trend,which showed a significantly lower value in proliferative phase than those in luteal phase （P = 0. 005）. The D values increased in the luteal phase vs. proliferative phase,and the difference was statistically significant （P = 0. 005）. The D^＊value is higher in the luteal phase than that in menstrual phase and proliferative phases （P 0. 01）. FA value decreased to the lowest point in the secretory phase when compared with that in the menstrual period （P = 0. 034）. Conclusion The value of D,D^＊,FA and ADC on the breast tissues of normal young volunteers are repeatable and may be potentially used to reflect breast tissue changes according to hormonal changes during menstrual cycle.

关 键 词：正常乳腺 月经周期 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]