Nan Zhou, Peipei Jiang, Yucan Chen, Ke Ma, Hui Zhu, Huanhuan Liang, Qing Hu, Yali Hu, Zhengyang Zhou, Kefeng Zhou
{"title":"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。","authors":"Nan Zhou, Peipei Jiang, Yucan Chen, Ke Ma, Hui Zhu, Huanhuan Liang, Qing Hu, Yali Hu, Zhengyang Zhou, Kefeng Zhou","doi":"10.1016/j.rbmo.2024.104776","DOIUrl":null,"url":null,"abstract":"<p><strong>Research question: </strong>Can diffusion-weighted imaging (DWI) be used to stage endometrial fibrosis?</p><p><strong>Design: </strong>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<sub>ROI</sub> and ADC<sub>VOI</sub>) and standard deviation (ADC-SD<sub>ROI</sub> and ADC-SD<sub>VOI</sub>) 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.</p><p><strong>Results: </strong>Endometrial thickness, endometrial ADC<sub>VOI</sub> and ADC<sub>ROI</sub> were significantly higher in healthy women (11.7 mm, 1.31 × 10<sup>-3</sup> mm<sup>2</sup>/s and 1.36 × 10<sup>-3</sup> mm<sup>2</sup>/s) than MMEF patients (7.5 mm, P < 0.001; 1.23 × 10<sup>-3</sup> mm<sup>2</sup>/s, P = 0.001; and 1.26 × 10<sup>-3</sup> mm<sup>2</sup>/s, P = 0.003) and SEF patients (6.2 mm, 1.15 × 10<sup>-3</sup> mm<sup>2</sup>/s and 1.23 × 10<sup>-3</sup> mm<sup>2</sup>/s; all P < 0.001). Endometrial ADC-SD<sub>VOI</sub> and ADC-SD<sub>ROI</sub> 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<sub>VOI</sub> and ADC<sub>ROI</sub> (Spearman's rho = -0.662, -0.526 and -0.349) and positively correlated with endometrial ADC-SD<sub>VOI</sub> and ADC-SD<sub>ROI</sub> (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).</p><p><strong>Conclusions: </strong>DWI is particularly effective for accurately staging the microstructural changes associated with endometrial fibrosis.</p>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":" ","pages":"104776"},"PeriodicalIF":3.7000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Non-invasive staging of endometrial fibrosis using diffusion-weighted imaging: a feasibility study.\",\"authors\":\"Nan Zhou, Peipei Jiang, Yucan Chen, Ke Ma, Hui Zhu, Huanhuan Liang, Qing Hu, Yali Hu, Zhengyang Zhou, Kefeng Zhou\",\"doi\":\"10.1016/j.rbmo.2024.104776\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Research question: </strong>Can diffusion-weighted imaging (DWI) be used to stage endometrial fibrosis?</p><p><strong>Design: </strong>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<sub>ROI</sub> and ADC<sub>VOI</sub>) and standard deviation (ADC-SD<sub>ROI</sub> and ADC-SD<sub>VOI</sub>) 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.</p><p><strong>Results: </strong>Endometrial thickness, endometrial ADC<sub>VOI</sub> and ADC<sub>ROI</sub> were significantly higher in healthy women (11.7 mm, 1.31 × 10<sup>-3</sup> mm<sup>2</sup>/s and 1.36 × 10<sup>-3</sup> mm<sup>2</sup>/s) than MMEF patients (7.5 mm, P < 0.001; 1.23 × 10<sup>-3</sup> mm<sup>2</sup>/s, P = 0.001; and 1.26 × 10<sup>-3</sup> mm<sup>2</sup>/s, P = 0.003) and SEF patients (6.2 mm, 1.15 × 10<sup>-3</sup> mm<sup>2</sup>/s and 1.23 × 10<sup>-3</sup> mm<sup>2</sup>/s; all P < 0.001). Endometrial ADC-SD<sub>VOI</sub> and ADC-SD<sub>ROI</sub> 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<sub>VOI</sub> and ADC<sub>ROI</sub> (Spearman's rho = -0.662, -0.526 and -0.349) and positively correlated with endometrial ADC-SD<sub>VOI</sub> and ADC-SD<sub>ROI</sub> (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).</p><p><strong>Conclusions: </strong>DWI is particularly effective for accurately staging the microstructural changes associated with endometrial fibrosis.</p>\",\"PeriodicalId\":21134,\"journal\":{\"name\":\"Reproductive biomedicine online\",\"volume\":\" \",\"pages\":\"104776\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-12-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reproductive biomedicine online\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.rbmo.2024.104776\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive biomedicine online","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.rbmo.2024.104776","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Non-invasive staging of endometrial fibrosis using diffusion-weighted imaging: a feasibility study.
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 (ADCROI and ADCVOI) and standard deviation (ADC-SDROI and ADC-SDVOI) 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 ADCVOI and ADCROI 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-SDVOI and ADC-SDROI 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 ADCVOI and ADCROI (Spearman's rho = -0.662, -0.526 and -0.349) and positively correlated with endometrial ADC-SDVOI and ADC-SDROI (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.
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.
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