Cine MRI of uterine peristalsis in patients with endometrial fibrosis.

Abstract

OBJECTIVE To assess uterine peristalsis using cine magnetic resonance imaging (MRI) in patients with different degrees of endometrial fibrosis. DESIGN A prospective observational cohort study. SUBJECTS A total of 75 patients with severe endometrial fibrosis, 40 patients with mild-to-moderate endometrial fibrosis, and 45 healthy women without uterine pathologies were included in the study. All patients of severe endometrial fibrosis and mild-to-moderate endometrial fibrosis were diagnosed by hysteroscopy. EXPOSURE Eligible women underwent MRI examination during the late proliferative phase. MAIN OUTCOME MEASURES Uterine static parameters including junctional zone thickness and its ratio to the total myometrial thickness, and cine parameters including peristaltic condition, frequency (/4min), intensity, and direction, were measured and analyzed. The study aimed to investigate the differences in uterine peristalsis across patients with different degrees of endometrial fibrosis using cine MRI. RESULTS Junctional zone thickness and its ratio to the total myometrial thickness were significantly higher in severe patients (6.1 mm, 95% Confidence Interval [CI]: 5.2-6.7 mm; 0.37±0.08) and mild-to-moderate patients (5.2 mm, 95% CI: 4.4-6.4 mm; 0.36±0.07) than in healthy women (3.9mm, 95% CI: 3.2-4.8 mm; 0.32±0.08) (all p <0.05). The percentage of detectable uterine peristalsis was significantly higher in healthy women (100%) than in severe patients (88.0%). Peristaltic frequency (/4min) and intensity were significantly higher in healthy women (10 times, 95% CI: 8-12 times; 3) than in mild-to-moderate patients (6 times, 95% CI: 4-9 times; 2) and severe patients (5 times, 95% CI: 4-7 times; 2) (all p <0.05).Mild-to-moderate patients and severe patients showed a higher percentage of the reverse and mixed peristaltic waves than healthy women (p <0.001). The degree of endometrial fibrosis was negatively correlated with peristaltic frequency and intensity but positively correlated with junctional zone thickness and its ratio to the total myometrial thickness (all p <0.05). The concordance of uterine static and cine parameters was excellent. CONCLUSION Cine MRI is particularly effective for assessing abnormalities in uterine peristalsis in patients with different degrees of endometrial fibrosis.