Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas
Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas
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DOI：
10.1016/j.ejrad.2004.01.009
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发表时间：
2005-01-01
影响因子：
3.3
通讯作者：
Fujii, S
中科院分区：
文献类型：
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作者：
Nishino, M;Togashi, K;Fujii, S
目的：粘膜下平滑肌瘤是不孕和习惯性流产的最常见原因之一。本研究的目的是评估子宫肌瘤患者的子宫脱垂，子宫周期相关的固有收缩性，可能负责精子运输和保存妊娠，使用电影磁共振（MR）成像。材料与方法：研究人群包括26例女性患者（年龄范围：19-51岁，平均年龄：41岁），其中16例患者患有粘膜下平滑肌瘤，10例患者患有壁内或浆膜下平滑肌瘤。我们使用1.5T磁体前瞻性地进行了子宫正中矢状面的MR成像（Symphony，Siemens Medical Systems），并获得60个半傅立叶采集单次激发快速自旋回波（HASTE）图像（回波时间= 80 ms，FOV = 300 rum，层厚5圈，矩阵256 x 256），并以比真实的速度快12倍的速度在电影模式下显示。评价子宫内膜-子宫肌层交界处的蠕动运动和邻近平滑肌瘤的局灶性子宫肌层运动，包括存在、方向、频率和传导。结果：16例粘膜下病变中12例出现蠕动，10例其他平滑肌瘤中10例出现蠕动。频率和方向与周期有关。在4/12例患者中观察到粘膜下肌瘤附近的纤维化丧失，但在其他患者中没有。9/16例粘膜下肌瘤患者出现局灶性肌层运动，其他患者未见。结论：子宫蠕动部分被粘膜下平滑肌瘤中断，但不被肌层或浆膜下平滑肌瘤中断。仅在粘膜下平滑肌瘤附近观察到增生消失和局灶性肌层运动。这些发现被认为代表了收缩功能障碍，可能与妊娠丢失有关。(C)2004爱思唯尔爱尔兰有限公司保留所有权利。
Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition Single Shot turbo spin echo (HASTE) images (Echo time = 80 ms, FOV = 300 rum, slice thickness 5 turn, matrix 256 x 256) within 2 min, and displayed them on cine mode at 12 x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss. (C) 2004 Elsevier Ireland Ltd. All rights reserved.