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哺乳期子宫形态及动态变化的磁共振成像

MR imaging of uterine morphology and dynamic changes during lactation.

作者信息

Daido Sayaka, Kido Aki, Kataoka Masako, Nakai Asako, Fujimoto Koji, Kusahara Hiroshi, Okada Tomohisa, Togashi Kaori

机构信息

Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University Hospital, Kyoto, Japan.

MRI systems Division, Toshiba Medical Systems Corporation, Tochigi, Japan.

出版信息

J Magn Reson Imaging. 2017 Feb;45(2):617-623. doi: 10.1002/jmri.25375. Epub 2016 Jul 15.

DOI:10.1002/jmri.25375
PMID:27417879
Abstract

PURPOSE

To investigate the influence of lactation and ovarian hormones on uterine morphology and function by comparing uteruses of lactating women with nulliparous women on MRI.

MATERIALS AND METHODS

Sagittal T2WI and cine MR images were obtained with 1.5 Tesla (T) and 3T scanner from 22 lactating women and 16 nulliparous women as a control group. The lactating group was further divided into amenorrhea and menorrhea subgroups. Uterine area, endometrial thickness, junctional zone (JZ) thickness, relative signal intensity (rSI) of the JZ, and of the outer myometrium (OM), were measured on T2-weighted fast spin echo images as static image parameters. Frequency of peristalsis (/3min), degree of endometrial transformation, subendometrial conduction, outer myometrial (OM) conduction, and sporadic myometrial contraction were evaluated using cine MR images. The above image parameters were compared between the lactating group and the control group, and between the lactational amenorrhea group and the lactational menorrhea group as a sub-analysis.

RESULTS

A significant difference was observed in all the static image parameters and in three of the five cine image parameters between the lactating group and the control group (P < 0.01). In sub-analysis, a statistical significance was found between the lactational amenorrhea group and lactational menorrhea group in area of the uterus and both endometrial and JZ thickness (P < 0.05), but not in cine image parameters (P = 0.682, P = 0.096, P = 0.191, P = 0.939, P = 0.289, respectively).

CONCLUSION

Uterine appearance and peristalsis were different between lactating and nulliparous women. The morphological differences were pronounced between lactating amenorrhea and menorrhea women.

LEVEL OF EVIDENCE

2 J. Magn. Reson. Imaging 2017;45:617-623.

摘要

目的

通过在磁共振成像(MRI)上比较哺乳期妇女和未生育妇女的子宫,研究哺乳和卵巢激素对子宫形态及功能的影响。

材料与方法

使用1.5特斯拉(T)和3T扫描仪,对22名哺乳期妇女和16名未生育妇女(作为对照组)进行矢状位T2WI和电影磁共振成像。哺乳期组进一步分为闭经和行经亚组。在T2加权快速自旋回波图像上测量子宫面积、子宫内膜厚度、结合带(JZ)厚度、JZ及外层肌层(OM)的相对信号强度(rSI),作为静态图像参数。使用电影磁共振成像评估蠕动频率(/3分钟)、子宫内膜转化程度、子宫内膜下传导、外层肌层(OM)传导及散在的肌层收缩情况。比较哺乳期组与对照组之间,以及作为亚分析的哺乳闭经组与哺乳行经组之间的上述图像参数。

结果

哺乳期组与对照组之间,所有静态图像参数以及五个电影图像参数中的三个均观察到显著差异(P < 0.01)。在亚分析中,哺乳闭经组与哺乳行经组在子宫面积、子宫内膜及JZ厚度方面存在统计学差异(P < 0.05),但在电影图像参数方面无差异(P分别为0.682、0.096、0.191、0.939、0.289)。

结论

哺乳期妇女与未生育妇女的子宫外观及蠕动情况不同。哺乳闭经妇女与哺乳行经妇女之间的形态学差异更为明显。

证据水平

2 J. Magn. Reson. Imaging 2017;45:617 - 623。

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