Cine magnetic resonance imaging of uterine peristalsis in patients with endometrial fibrosis.

OBJECTIVE

To assess uterine peristalsis using cine magnetic resonance imaging (MRI) in patients with different degrees of endometrial fibrosis.

DESIGN

A prospective observational cohort study.

SUBJECTS

A total of 75 patients with severe endometrial fibrosis, 40 patients with mild-to-moderate endometrial fibrosis, and 45 healthy women without uterine pathologies were included in the study. All patients with severe endometrial fibrosis and mild-to-moderate endometrial fibrosis were diagnosed by hysteroscopy.

EXPOSURE

Eligible women underwent MRI examination during the late proliferative phase.

MAIN OUTCOME MEASURES

Uterine static parameters including junctional zone thickness and its ratio to the total myometrial thickness and cine parameters including peristaltic condition, frequency (per 4 minutes), intensity, and direction were measured and analyzed. The study aimed to investigate the differences in uterine peristalsis across patients with different degrees of endometrial fibrosis using cine MRI.

RESULTS

Junctional zone thickness and its ratio to the total myometrial thickness were significantly higher in patients with severe endometrial fibrosis (6.1 mm; 95% confidence interval [CI], 5.2-6.7 mm; 0.37 ± 0.08) and patients with mild-to-moderate endometrial fibrosis (5.2 mm; 95% CI, 4.4-6.4 mm; 0.36 ± 0.07) than in healthy women (3.9 mm; 95% CI, 3.2-4.8 mm; 0.32 ± 0.08). The percentage of detectable uterine peristalsis was significantly higher in healthy women (100%) than in patients with severe endometrial fibrosis (88.0%). Peristaltic frequency (per 4 minutes) and intensity were significantly higher in healthy women (10 times; 95% CI, 8-12 times; 3) than in patients with mild-to-moderate endometrial fibrosis (6 times; 95% CI, 4-9 times; 2) and patients with severe endometrial fibrosis (5 times; 95% CI, 4-7 times; 2). Patients with mild-to-moderate endometrial fibrosis and patients with severe endometrial fibrosis showed a higher percentage of the reverse and mixed peristaltic waves than healthy women. The degree of endometrial fibrosis was negatively correlated with peristaltic frequency and intensity but positively correlated with junctional zone thickness and its ratio to the total myometrial thickness. The concordance of uterine static and cine parameters was excellent.

CONCLUSION

Cine MRI is particularly effective for assessing abnormalities in uterine peristalsis in patients with different degrees of endometrial fibrosis.