Nakai Asako, Togashi Kaori, Kosaka Kenzo, Kido Aki, Kataoka Masako, Koyama Takashi, Fujii Shingo
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Radiology. 2008 Feb;246(2):489-96. doi: 10.1148/radiol.2461062091. Epub 2007 Dec 19.
To prospectively evaluate anticholinergic drug effects on uterine peristalsis and sporadic myometrial contractions, as well as on intestinal motion, with cine magnetic resonance (MR) imaging.
This prospective study was approved by the institutional review board; informed consent was obtained from all participants. Twenty-one women (mean age, 29.3 years +/- 4.0 [standard deviation]) underwent MR imaging during the follicular through periovulatory phases (cycle days 5-26). Before and after injection of an anticholinergic agent, 60 serial half-Fourier rapid acquisition with relaxation enhancement MR images were obtained within 2 minutes in the midsagittal uterine plane. Evaluations were performed independently and separately in random order by two radiologists who were blinded to whether an anticholingeric agent had been administered. Uterine peristalsis was evaluated for frequency (paired t test), predominant direction (McNemar test), degree of endometrial movement, wave conduction in the junctional zone (JZ), and wave conduction toward the outer myometrium (Wilcoxon signed rank test). Degree of sporadic contractions in the outer myometrium and intestinal motion were also evaluated (Wilcoxon signed rank test).
On postinjection images, uterine peristalsis decreased in frequency from 4.57 waves per 2 minutes +/- 1.62 to 3.52 waves per 2 minutes +/- 1.59, which is a 23% (95% confidence interval: 8.7%, 37.2%) average reduction (P = .003). There was no significant difference in actual predominant uterine peristalsis direction between pre- and postinjection images (P > .99). Although there were trends toward reduction of the degree of endometrial movement and of wave conduction in the JZ and toward the outer myometrium, these were not significant. The degree of sporadic myometrial contractions (P = .001) and intestinal motion (P < .001) decreased on postinjection images.
Anticholinergic agents significantly suppress sporadic myometrial contractions and uterine peristalsis, in addition to intestinal motion, all of which may contribute to improved quality of conventional uterine MR images.
通过电影磁共振（MR）成像前瞻性评估抗胆碱能药物对子宫蠕动、散在的子宫肌层收缩以及肠道运动的影响。
本前瞻性研究经机构审查委员会批准；所有参与者均获得知情同意。21名女性（平均年龄29.3岁±4.0[标准差]）在卵泡期至排卵前期（月经周期第5 - 26天）接受MR成像检查。在注射抗胆碱能药物前后，于子宫矢状面中部2分钟内获取60幅连续的半傅里叶单次激发快速自旋回波MR图像。由两名对是否给予抗胆碱能药物不知情的放射科医生按照随机顺序独立且分别进行评估。评估子宫蠕动的频率（配对t检验）、主要方向（McNemar检验）、子宫内膜运动程度、结合带（JZ）的波传导以及向外肌层的波传导（Wilcoxon符号秩检验）。还评估了外肌层散在收缩的程度和肠道运动（Wilcoxon符号秩检验）。
注射后图像上，子宫蠕动频率从每2分钟4.57次±1.62次降至每2分钟3.52次±1.59次，平均降低23%（95%置信区间：8.7%，37.2%）（P = 0.003）。注射前后图像上子宫实际主要蠕动方向无显著差异（P > 0.99）。虽然子宫内膜运动程度、JZ及向外肌层的波传导有降低趋势，但不显著。注射后图像上散在子宫肌层收缩程度（P = 0.001）和肠道运动（P < 0.001）降低。
抗胆碱能药物可显著抑制散在的子宫肌层收缩、子宫蠕动以及肠道运动，所有这些可能有助于提高传统子宫MR图像的质量。
