Jain Varsha, Hojo Emi, McKillop Graham, Oniscu Anca, Le Yuan, Chen Jun, Ehman Richard, Roberts Neil, Critchley Hilary O D
Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom; Simpson's Centre for Repoductive Health, Royal Infirmary Edinburgh, Edinburgh, United Kingdom.
Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom; Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota.
F S Sci. 2025 May;6(2):242-251. doi: 10.1016/j.xfss.2025.03.003. Epub 2025 Mar 25.
Magnetic resonance elastography (MRE), a novel imaging technique that allows in vivo measurement of tissue mechanical properties, was used to test the prediction that the stiffness of the uterus may be increased due to fibrotic changes in patients with adenomyosis.
A feasibility study in which a 3-dimensional (3D) MRE imaging protocol was developed to measure the stiffness of the tissues of the uterus.
Four patients with suspected adenomyosis and heavy menstrual bleeding diagnosed via transvaginal ultrasound and clinical history and 1 healthy control were recruited. Two patients underwent hysterectomy, and histologic analysis of the tissue samples was performed.
The stiffness of the whole uterus was obtained by region of interest analysis of the 3D MRE images for the 4 patients and 1 healthy control. In addition, for the 2 patients who underwent hysterectomy, the uterine tissue samples were assessed to determine histologic presence of adenomyosis via hematoxylin and eosin staining, cellular/molecular measures of tissue stiffness (collagen [picrosirius red], α-smooth muscle actin, and e-cadherin), and whether a relationship existed between in vivo assessment of the uterus via 3D MRE and in vitro uterine tissue histology.
3D MRE was successfully used to acquire elastograms for 4 patients with adenomyosis (diffuse, n = 3; focal, n = 1) and 1 healthy control. Calculated global uterine stiffness was higher in women with adenomyosis (2.93 kPa; range, 2.34-3.39 kPa) than in the healthy control (2.04 kPa). Regions of high stiffness on the 3D elastograms reflected adenomyotic changes visualized via conventional magnetic resonance imaging and were correlated with histologic and immunohistochemical markers of tissue stiffness.
3D MRE has the potential to provide non-invasive characterization of changes in the mechanical properties of uterine tissue that is not possible using conventional magnetic resonance imaging or transvaginal ultrasound. Further studies are needed to confirm the efficacy of the 3D MRE protocol for diagnosing adenomyosis.
磁共振弹性成像（MRE）是一种能够在体内测量组织力学特性的新型成像技术，本研究旨在验证子宫腺肌病患者因纤维化改变导致子宫硬度增加这一预测。
一项可行性研究，其中开发了一种三维（3D）MRE成像方案来测量子宫组织的硬度。
招募了4例经阴道超声及临床病史诊断为疑似子宫腺肌病且月经过多的患者和1例健康对照。2例患者接受了子宫切除术，并对组织样本进行了组织学分析。
通过对4例患者和1例健康对照的3D MRE图像进行感兴趣区域分析，获得整个子宫的硬度。此外，对于2例接受子宫切除术的患者，通过苏木精和伊红染色、组织硬度的细胞/分子测量指标（胶原[苦味酸天狼星红]、α平滑肌肌动蛋白和E-钙黏蛋白）评估子宫组织样本，以确定子宫腺肌病的组织学存在情况，并确定通过3D MRE对子宫进行的体内评估与体外子宫组织学之间是否存在关联。
3D MRE成功用于获取4例子宫腺肌病患者（弥漫性，n = 3；局灶性，n = 1）和1例健康对照的弹性成像图。子宫腺肌病患者计算出的整体子宫硬度（2.93 kPa；范围为2.34 - 3.39 kPa）高于健康对照（2.04 kPa）。3D弹性成像图上的高硬度区域反映了通过传统磁共振成像观察到的子宫腺肌病变化，并与组织硬度的组织学和免疫组化标记物相关。
3D MRE有可能对子宫组织力学特性的变化进行非侵入性表征，而这是传统磁共振成像或经阴道超声无法做到的。需要进一步研究以确认3D MRE方案在诊断子宫腺肌病方面的有效性。
