Katrin Hegenscheid MD, Presenter: Nothing to Disclose

Carsten Oliver Schmidt, Abstract Co-Author: Nothing to Disclose

Birger Mensel MD, Abstract Co-Author: Nothing to Disclose

Rebecca Seipel MD, Abstract Co-Author: Nothing to Disclose

Rene Laqua, Abstract Co-Author: Nothing to Disclose

Norbert Hosten MD, Abstract Co-Author: Nothing to Disclose

Ralf Puls MD, Abstract Co-Author: Nothing to Disclose

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

Institutional review board approval and informed consent were obtained.A total of 459 women (mean age ± standard deviation 49.1±12.5 years) underwent MRM using T1-weighted 3D scans acquired at 1.5T 1 to 5 min after a gadobutrol injection of 0.1mmol/kg body weight. Quantitative analysis was performed in normal breast parenchyma by manually tracing regions of interest and calculating percent CE.Semiquantitative analysis was performed in non-mass-like enhancing areas, and signal intensity changes were characterized by five predefined kinetic curves types ranging from minimal continuous CE (curve type I) to strong CE during the first 2 min followed by wash out (curve type V).The influence of OC and HT on CE was studied using random effects models.

CE of normal breast parenchyma was approximately 30% higher premenopausal (p<0.001). Mean enhancement was 11.51%, 19.83%, 25.54%, 30.13%, and 33.74% in premenopausal women and decreased significantly (p<0.001) to 6.07%, 10.72%, 14.88%, 18.27%, and 20.27% in postmenopausal women at 1 to 5 min after contrast, respectively.CE decreased significantly with the use of OC (p=0.01) but was similar in HT users and non-HT users (p=0.52). A subanalysis of HT compositions yielded similar results for estrogen only users (p= 0.43) and for users of progestogens and estrogens in combination (p= 0.63).Prevalence of kinetic curve types of non-mass-like enhancement differed strongly between pre- and postmenopausal women (p<0.0001). In premenopausal women curve types II and III were more common. Subgroup analysis showed marginal differences in the distribution of curve types between OC users and non-OC users (p= 0.61) as well as HT and non-HT users (p= 0.77).

CE of normal breast parenchyma and non-mass-like enhancing areas was strongly affected by menopausal status, while it was not affected by HT use and only moderately by OC use.

The higher contrast enhancement of normal breast parenchyma and greater prevalence of lesions with strong continuous non-mass-like enhancement in premenopausal women may obscure non-mass lesions.

Hegenscheid, K, Schmidt, C, Mensel, B, Seipel, R, Laqua, R, Hosten, N, Puls, R, Contrast Enhancement Kinetics of Normal Breast Parenchyma in Dynamic MR Mammography – Effects of Menopausal Status, Oral Contraceptives and Postmenopausal Hormone Therapy.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043392.html