Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
Sci Rep. 2021 Jun 18;11(1):12887. doi: 10.1038/s41598-021-92383-w.
Recently, few noninvasive methods have been reported to evaluate endometrial fibrosis. Our study was to investigate the feasibility of intravoxel incoherent motion (IVIM) MR imaging in the detection of endometrial fibrosis in patients with intrauterine injury. 30 patients with hysteroscopy-confirmed endometrial fibrosis and 28 healthy women were enrolled to undergo MR examination including the IVIM sequence. Endometrial thickness (ET); apparent diffusion coefficient (ADC); and IVIM parameters, including pure diffusion coefficient (D), pseudodiffusion coefficient (D*) and vascular fraction (f) were evaluated. A multivariable model combing ADC, D, and f values using binary logistic regression analysis was built to diagnose endometrial fibrosis. Endometrial fibrosis patients demonstrated lower endometrial ADC, D, f values and ET (all p < 0.05). The multivariable model, ADC, D, f values and ET performed well in diagnosing endometrial fibrosis with AUC of 0.979, 0.965, 0.920, 0.901 and 0.833, respectively. The multivariable model revealed a better diagnostic accuracy than D, f and ET (all p < 0.05). Although ADC achieved a better diagnostic value than ET (z = 2.082, p < 0.05), no difference in AUC was shown among ADC, D, and f (all p > 0.05); between ET and D (p > 0.05); and between ET and f (p > 0.05). The reproducibility of ADC, D, f and D* values in patients with endometrial fibrosis and healthy women were good to excellent (ICC: 0.614-0.951). IVIM parameters exhibit promising potential to serve as imaging biomarkers in the noninvasive assessment of endometrial fibrosis.
最近，有一些非侵入性的方法被报道用于评估子宫内膜纤维化。我们的研究旨在探讨磁共振体素内不相干运动（IVIM）成像在宫腔内损伤患者子宫内膜纤维化检测中的可行性。30 例经宫腔镜证实的子宫内膜纤维化患者和 28 例健康女性接受了包括 IVIM 序列在内的 MRI 检查。评估了子宫内膜厚度（ET）；表观扩散系数（ADC）；以及 IVIM 参数，包括纯扩散系数（D）、假性扩散系数（D*）和血管分数（f）。使用二元逻辑回归分析，结合 ADC、D 和 f 值的多变量模型构建用于诊断子宫内膜纤维化。子宫内膜纤维化患者的子宫内膜 ADC、D、f 值和 ET 均较低（均 P < 0.05）。多变量模型、ADC、D、f 值和 ET 在诊断子宫内膜纤维化方面表现良好，AUC 分别为 0.979、0.965、0.920、0.901 和 0.833。多变量模型显示出比 D、f 和 ET 更好的诊断准确性（均 P < 0.05）。尽管 ADC 的诊断价值优于 ET（z = 2.082，P < 0.05），但在 ADC、D 和 f 之间的 AUC 没有差异（均 P > 0.05）；在 ET 和 D 之间（P > 0.05）；以及在 ET 和 f 之间（P > 0.05）。子宫内膜纤维化患者和健康女性的 ADC、D、f 和 D*值的可重复性良好到极好（ICC：0.614-0.951）。IVIM 参数具有作为子宫内膜纤维化无创评估的成像生物标志物的潜在应用价值。
