Dynamic contrast-enhanced MR imaging to assess physiologic variations of myometrial

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Dynamic contrast-enhanced MRI revealed distinct microvascular parameter differences between the inner and outer myometrium, along with menstrual cycle-dependent variations and postmenopausal changes.

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Abstract

Purpose: To prospectively evaluate the ability of dynamic con- trast-enhanced magnetic resonance imaging (DCE-MRI) to assess phys- iological microvascular states in nor- mal myometrium. Materials and methods: Eighty-five women (62 women of reproductive age, 23 post- menopausal) undergoing DCE-MRI of the pelvis were included. Micro- vascular parameters for the inner and outer myometrium were analysed using a pharmacokinetic model. These parameters were tissue blood flow (F), blood volume fraction (Vb), permeability-surface area product (PS), interstitial volume fraction (Ve) and lag time (Dt). Results: In the women of reproductive age, the inner myometrium displayed higher F and PS, lower Vb and Ve, and longer Dt than the outer myometrium (p=0.02, p=0.01, p=0.005, p=0.03 and p= 0.01, respectively). The inner myo- metrium presented microvascular variations during the menstrual cycle with a pre-ovulatory peak followed by a fall reaching a nadir of F and Vb about 4 days after ovulation. Com- pared with women of reproductive age, in the postmenopausal state, F and Vb decreased in the outer myo- metrium, while PS, Ve and Dt in- creased (p<0.0001, p=0.001, p= 0.001, p=0.03 and p=0.0004, re- spectively). Conclusion: DCE-MRI is a non-invasive technique that can measure variations of myometrial microcirculation, and thereby be po- tentially useful to help characterize the role and states of the myometrium in assisted reproductive therapy.

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