Dynamic contrast-enhanced MR imaging to assess physiologic variations of myometrial perfusion.
OBJECTIVE
To prospectively evaluate the ability of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to assess physiological microvascular states in normal myometrium.


METHODS
Eighty-five women (62 women of reproductive age, 23 postmenopausal) undergoing DCE-MRI of the pelvis were included. Microvascular parameters for the inner and outer myometrium were analysed using a pharmacokinetic model. These parameters were tissue blood flow (F), blood volume fraction (V(b)), permeability-surface area product (PS), interstitial volume fraction (V(e)) and lag time (Dt).


RESULTS
In the women of reproductive age, the inner myometrium displayed higher F and PS, lower V(b) and V(e), 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 myometrium presented microvascular variations during the menstrual cycle with a pre-ovulatory peak followed by a fall reaching a nadir of F and V(b) about 4 days after ovulation. Compared with women of reproductive age, in the postmenopausal state, F and V(b) decreased in the outer myometrium, while PS, V(e) and Dt increased (p < 0.0001, p = 0.001, p = 0.001, p = 0.03 and p = 0.0004, respectively).


CONCLUSIONS
DCE-MRI is a non-invasive technique that can measure variations of myometrial microcirculation, and thereby be potentially useful to help characterize the role and states of the myometrium in assisted reproductive therapy.
Thomassin-Naggara
Isabelle
I
Department of Radiology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France. isabellethomassin@gmail.com
Balvay
Daniel
D
Cuenod
Charles A
CA
Daraï
Emile
E
Marsault
Claude
C
Bazot
Marc
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001783:Blood Flow Velocity; D003198:Computer Simulation; D003287:Contrast Media / Q000493:pharmacokinetics; D005240:Feasibility Studies; D005260:Female; D005682:Gadolinium / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007700:Kinetics; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008597:Menstrual Cycle / Q000378:metabolism*; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D008954:Models, Biological; D009215:Myometrium / Q000098:blood supply / Q000502:physiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
D003287:Contrast Media; D005682:Gadolinium