CAJ | 학술논문

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。
목적：탐토정상유선조직재불동월경상태화불동년령단자공진체소내불상간운동（IVIM）성상각삼수치변화정황。방법공유375례녀성수시자납입연구，기중절경전302례，절경후73례。근거년령고저，장절경전수시자분위저、중、고삼개년령조，병근거월경주기불동계단장매개년령조수시자분위오개아조（월경기、증식기、란포기、황체기、분비기）。채용10개b치（0、10、20、50、100、200、300、400、600、800 s/mm2）적IVIM성상방법，대소유수시자진행유선자공진IVIM검사，기우감흥취구（ROI），측량정상유선조직적진실미산계수（D）、관주상관미산계수（D*）화혈관용적분수（f）。사용단인소방차분석수시자월경주기불동계단이급절경전후IVIM각삼수치적차이。결과절경후수시자정상유선조직D치화D*치교절경전수시자명현하강。절경전정상유선조직D치（저、중、고년령조）화D*치（저、중년령조）수월경주기각계단정현유규률적파동：황체기혹란포기수치교고，이기타각기수치상대교저。란포기여황체기D치화D*치유고도저배렬위：저년령조、중년령조、고년령조。분비기D치유고도저배렬위：저년령조、중년령조、고년령조。결론자공진IVIM성상가이정량반영월경상태대우정상유선조직적영향。재사용IVIM진단유선병변시응해충분인식도월경상태이급년령인소대IVIM각삼수치적영향。
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.