Department of Gynecology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China.
Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China.
Diagn Interv Radiol. 2023 Sep 5;29(5):656-663. doi: 10.4274/dir.2023.232188. Epub 2023 Aug 9.
This study aimed to compare the variability of the uterus during the menses phase (MP), follicular phase (FP), and luteal phase (LP) of the menstrual cycle using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI).
This prospective study was conducted at the Guangdong Provincial Hospital of Traditional Chinese Medicine between January 2022 and January 2023. Women of childbearing age (18-45 years) with appropriate progesterone levels were included in this study. Conventional magnetic resonance imaging and IVIM-DWI scans were performed during the MP, FP, and LP. The differences in IVIM-DWI-derived parameters between these phases were then compared, and the overlap was quantitatively described.
The apparent diffusion coefficient (ADC) and pure molecular diffusion coefficient () values from the endometrium, uterine junctional zone (UJZ), and myometrium indicated statistical differences between the MP and FP and the MP and LP (ADC: endometrium, both < 0.001; UJZ, = 0.008 and < 0.001, respectively; myometrium, = 0.033 and = 0.006, respectively; D: endometrium, both < 0.001; UJZ, = 0.008 and = 0.006, respectively; myometrium, = 0.041 and = 0.045, respectively). The perfusion-related diffusion coefficient () values from the myometrium indicated statistical differences between the FP and MP and the FP and LP (: myometrium, = 0.049 and = 0.009, respectively). The overlapping endometrium ratios between the MP and FP or LP were lower than 50% in the ADC and values (ADC: overlapping of MP and FP: 33.33%, overlapping of MP and LP: 23.33%; : overlapping of MP and FP: 40.00%, overlapping of MP and LP: 43.33%).
The ADC and IVIM-derived parameters indicated differences in the uterus in diverse phases of the menstrual cycle, especially in the endometrium in relation to ADC and values.
本研究旨在通过体素内不相干运动扩散加权成像（IVIM-DWI）比较子宫在月经周期的月经期（MP）、卵泡期（FP）和黄体期（LP）的变化。
本前瞻性研究于 2022 年 1 月至 2023 年 1 月在广东省中医院进行，纳入年龄在 18-45 岁之间、孕激素水平适当的生育期女性。在 MP、FP 和 LP 期间进行常规磁共振成像和 IVIM-DWI 扫描。然后比较这些阶段的 IVIM-DWI 衍生参数之间的差异，并进行定量描述。
子宫内膜、子宫结合区（UJZ）和子宫肌层的表观扩散系数（ADC）和纯分子扩散系数（D）值在 MP 和 FP 以及 MP 和 LP 之间存在统计学差异（ADC：子宫内膜，均<0.001；UJZ，=0.008 和<0.001，分别；子宫肌层，=0.033 和=0.006，分别；D：子宫内膜，均<0.001；UJZ，=0.008 和=0.006，分别；子宫肌层，=0.041 和=0.045，分别）。子宫肌层的灌注相关扩散系数（D*）值在 FP 和 MP 以及 FP 和 LP 之间存在统计学差异（=0.049 和=0.009，分别）。MP 和 FP 或 LP 之间的重叠子宫内膜比值在 ADC 和 D 值低于 50%（ADC：MP 和 FP 重叠：33.33%；MP 和 LP 重叠：23.33%；D：MP 和 FP 重叠：40.00%；MP 和 LP 重叠：43.33%）。
ADC 和 IVIM 衍生参数表明子宫在月经周期的不同阶段存在差异，特别是在与 ADC 和 D 值相关的子宫内膜方面。
