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Contrast enhancement kinetics of normal breast parenchyma in dynamic MR mammography: effects of menopausal status, oral contraceptives, and postmenopausal hormone therapy

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Abstract

Objectives

To investigate effects of menopausal status, oral contraceptives (OC), and postmenopausal hormone therapy (HT) on normal breast parenchymal contrast enhancement (CE) and non-mass-like enhancing areas in magnetic resonance mammography (MRM).

Methods

A total of 459 female volunteers (mean age 49.1 ± 12.5 years) underwent T1-weighted 3D MRM 1–5 min after bolus injection of gadobutrol. Quantitative analysis was performed in normal breast parenchyma by manually tracing regions of interest and calculating percentage CE. Semiquantitative analysis was performed in non-mass-like enhancing areas, and signal intensity changes were characterised by five predefined kinetic curve types. The influence of OC (n = 69) and HT (n = 24) on CE was studied using random effects models.

Results

Breast parenchymal enhancement was significantly higher in premenopausal than in postmenopausal women (P < 0.001). CE decreased significantly with the use of OC (P = 0.01), while HT had negligible effects (P = 0.52). Prevalence of kinetic curve types of non-mass-like enhancement differed strongly between pre- and postmenopausal women (P < 0.0001), but was similar in OC users and non-OC users (P = 0.61) as well as HT users and non-HT users (P = 0.77).

Conclusions

Normal breast parenchymal enhancement and non-mass-like enhancing areas were strongly affected by menopausal status, while they were not affected by HT use and only moderately by OC use.

Key Points

• Breast parenchymal enhancement at MR mammography is stronger in premenopausal than postmenopausal women.

• The prevalence of strong enhancing non-mass-like areas is greater before menopause.

• Such enhancing non-mass-like areas may impair lesion detection in premenopausal women.

• Breast parenchymal enhancement is only marginally affected by hormone use.

• Discontinuation of hormone use before MR mammography may be unnecessary.

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Abbreviations

ATC:

Anatomical Therapeutic Chemical classification system

BI-RADS:

Breast Imaging-Reporting and Data System

BMI:

Body mass index

CE:

Contrast enhancement

HT:

Postmenopausal hormone therapy

MRM:

Magnetic resonance mammography

OC:

Oral contraceptives

ROI:

Region of interest

TWIST:

Time-resolved angiography with stochastic trajectories

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Acknowledgements

SHIP is part of the Community Medicine Research Net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant No. 03ZIK012), the Ministry of Cultural Affairs as well as the Social Ministry of the Federal State of Mecklenburg-West Pomerania. Whole-body MR imaging was supported by a joint grant from Siemens Healthcare, Erlangen, Germany, and the Federal State of Mecklenburg-West Pomerania. The University of Greifswald is a member of the ‘Center of Knowledge Interchange’ program of Siemens AG. Dynamic contrast-enhanced MR mammography research is part of the entire whole-body MRI study and was supported by Bayer Healthcare.

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Authors and Affiliations

  1. Department of Diagnostic Radiology and Neuroradiology, Ernst-Moritz-Arndt University Medical Center Greifswald, Ferdinand-Sauerbruch-Strasse 1, 17475, Greifswald, Germany

    Katrin Hegenscheid, Rebecca Seipel, René Laqua, Norbert Hosten & Ralf Puls

  2. Institute for Community Medicine, Ernst-Moritz-Arndt University Medical Center Greifswald, Walther-Rathenau-Strasse 48, 17475, Greifswald, Germany

    Carsten O. Schmidt

  3. Department of Gynecology and Obstetrics, Ernst-Moritz-Arndt University Medical Center Greifswald, Ferdinand-Sauerbruch-Straße 1, Greifswald, Germany

    Ralf Ohlinger

Authors
  1. Katrin Hegenscheid
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  2. Carsten O. Schmidt
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Correspondence to Katrin Hegenscheid.

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Hegenscheid, K., Schmidt, C.O., Seipel, R. et al. Contrast enhancement kinetics of normal breast parenchyma in dynamic MR mammography: effects of menopausal status, oral contraceptives, and postmenopausal hormone therapy. Eur Radiol 22, 2633–2640 (2012). https://doi.org/10.1007/s00330-012-2544-9

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  • DOI: https://doi.org/10.1007/s00330-012-2544-9

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