Non-invasive staging of endometrial fibrosis using diffusion-weighted imaging: a feasibility study.

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online Pub Date : 2024-12-20 DOI:10.1016/j.rbmo.2024.104776

Nan Zhou, Peipei Jiang, Yucan Chen, Ke Ma, Hui Zhu, Huanhuan Liang, Qing Hu, Yali Hu, Zhengyang Zhou, Kefeng Zhou

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引用次数: 0

Abstract

Research question: Can diffusion-weighted imaging (DWI) be used to stage endometrial fibrosis?

Design: This prospective study included 41 healthy women, 30 patients with mild to moderate endometrial fibrosis (MMEF) and 102 patients with severe endometrial fibrosis (SEF). Endometrial thickness and DWI-related parameters, specifically the mean intensity (ADC_ROI and ADC_VOI) and standard deviation (ADC-SD_ROI and ADC-SD_VOI) of the endometrial apparent diffusion coefficient (ADC) values within a region of interest (ROI) on a mid-sagittal ADC map, and volume of interest (VOI) of the entire endometrium in the corpus uteri, were measured and analysed.

Results: Endometrial thickness, endometrial ADC_VOI and ADC_ROI were significantly higher in healthy women (11.7 mm, 1.31  ×  10^-3 mm²/s and 1.36  ×  10^-3 mm²/s) than MMEF patients (7.5 mm, P < 0.001; 1.23  ×  10^-3 mm²/s, P = 0.001; and 1.26  ×  10^-3 mm²/s, P = 0.003) and SEF patients (6.2 mm, 1.15  ×  10^-3 mm²/s and 1.23  ×  10^-3 mm²/s; all P < 0.001). Endometrial ADC-SD_VOI and ADC-SD_ROI were significantly higher in SEF patients (0.24 and 0.24) than healthy women (0.16 and 0.13) and MMEF patients (0.18 and 0.16) (all P < 0.001). The degree of endometrial fibrosis was negatively correlated with endometrial thickness, endometrial ADC_VOI and ADC_ROI (Spearman's rho = -0.662, -0.526 and -0.349) and positively correlated with endometrial ADC-SD_VOI and ADC-SD_ROI (Spearman's rho 0.729 and 0.713) (all P < 0.001). Compared with endometrial thickness measurements, endometrial magnetic resonance imaging parameters, particularly DWI-related parameters, demonstrated excellent accuracy in distinguishing normal endometrium, MMEF and SEF (areas under the curve >0.800).

Conclusions: DWI is particularly effective for accurately staging the microstructural changes associated with endometrial fibrosis.

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应用弥散加权成像对子宫内膜纤维化进行无创分期：可行性研究。

研究问题：弥散加权成像（DWI）可以用于子宫内膜纤维化分期吗？设计：这项前瞻性研究包括41名健康女性，30名轻度至中度子宫内膜纤维化（MMEF）患者和102名重度子宫内膜纤维化（SEF）患者。测量和分析子宫内膜厚度和dwi相关参数，特别是中矢状面ADC图上感兴趣区域（ROI）内子宫内膜表观扩散系数（ADC）值的平均强度（ADCROI和ADCVOI）和标准差（ADC- sdroi和ADC- sdvoi），以及整个子宫内膜的感兴趣体积（VOI）。结果：健康女性子宫内膜厚度、ADCVOI和ADCROI （11.7 mm， 1.31 × 10-3 mm2/s和1.36 × 10-3 mm2/s）显著高于MMEF患者(7.5 mm, P < 0.001；1.23 × 10-3 mm2/s, P = 0.001；1.26 × 10-3 mm2/s, P = 0.003)和SEF患者（6.2 mm， 1.15 × 10-3 mm2/s和1.23 × 10-3 mm2/s）；P < 0.001)。子宫内膜ADC-SDVOI和ADC-SDROI在SEF组（0.24和0.24）明显高于健康组（0.16和0.13）和MMEF组（0.18和0.16）（均P < 0.001）。子宫内膜纤维化程度与子宫内膜厚度、子宫内膜ADCVOI、ADCROI呈负相关（Spearman’s rho = -0.662、-0.526、-0.349），与子宫内膜ADC-SDVOI、ADC-SDROI呈正相关（Spearman’s rho 0.729、0.713）（均P < 0.001）。与子宫内膜厚度测量相比，子宫内膜磁共振成像参数，特别是dwi相关参数，在区分正常子宫内膜、MMEF和SEF（曲线下面积>0.800）方面表现出极好的准确性。结论：DWI对于准确分期与子宫内膜纤维化相关的微结构变化特别有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reproductive biomedicine online 医学-妇产科学

CiteScore

7.20

自引率

7.50%

发文量

391

审稿时长

50 days

期刊介绍： Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.