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1.
Lancet Oncol ; 25(3): e114-e125, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38423057

RESUMO

Non-surgical ablation is emerging as an alternative local therapy option for patients with early-stage breast cancer and encompasses two main types of percutaneous therapeutic procedures: radiofrequency ablation and cryoablation. Both techniques involve obliteration of a spherical lesion and feasibility studies have shown that complete tumour ablation is achievable with good or excellent cosmetic results. Although few clinical studies have directly compared non-surgical ablation with conventional surgical resection, observational studies indicate that clinical outcomes are favourable with acceptable rates of local control and no detriment to long-term survival. There remain outstanding issues with these percutaneous ablative techniques that require resolution before they could be incorporated into routine clinical practice. Hence, a consensus meeting was convened to discuss the challenges of non-surgical ablation and clarify indications for its use alongside clinical management pathways. In this Policy Review we will address some of the broader biological aspects of non-surgical ablation, including immune-modulatory effects and potential novel applications for the future.


Assuntos
Neoplasias da Mama , Ablação por Cateter , Feminino , Humanos , Neoplasias da Mama/cirurgia , Consenso , Procedimentos Clínicos
2.
J Magn Reson Imaging ; 2023 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-38085134

RESUMO

The development of ultrafast dynamic contrast-enhanced (UF-DCE) MRI has occurred in tandem with fast MRI scan techniques, particularly view-sharing and compressed sensing. Understanding the strengths of each technique and optimizing the relevant parameters are essential to their implementation. UF-DCE MRI has now shifted from research protocols to becoming a part of clinical scan protocols for breast cancer. UF-DCE MRI is expected to compensate for the low specificity of abbreviated MRI by adding kinetic information from the upslope of the time-intensity curve. Because kinetic information from UF-DCE MRI is obtained from the shape and timing of the initial upslope, various new kinetic parameters have been proposed. These parameters may be associated with receptor status or prognostic markers for breast cancer. In addition to the diagnosis of malignant lesions, more emphasis has been placed on predicting and evaluating treatment response because hyper-vascularity is linked to the aggressiveness of breast cancers. In clinical practice, it is important to note that breast lesion images obtained from UF-DCE MRI are slightly different from those obtained by conventional DCE MRI in terms of morphology. A major benefit of using UF-DCE MRI is avoidance of the marked or moderate background parenchymal enhancement (BPE) that can obscure the target enhancing lesions. BPE is less prominent in the earlier phases of UF-DCE MRI, which offers better lesion-to-noise contrast. The excellent contrast of early-enhancing vessels provides a key to understanding the detailed pathological structure of tumor-associated vessels. UF-DCE MRI is normally accompanied by a large volume of image data for which automated/artificial intelligence-based processing is expected to be useful. In this review, both the theoretical and practical aspects of UF-DCE MRI are summarized. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 2.

3.
Eur Radiol ; 33(11): 8132-8141, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37286791

RESUMO

OBJECTIVE: Triple-negative breast cancer (TNBC) is a highly proliferative breast cancer subtype. We aimed to identify TNBC among invasive cancers presenting as masses using maximum slope (MS) and time to enhancement (TTE) measured on ultrafast (UF) DCE-MRI, ADC measured on DWI, and rim enhancement on UF DCE-MRI and early-phase DCE-MRI. METHODS: This retrospective single-center study, between December 2015 and May 2020, included patients with breast cancer presenting as masses. Early-phase DCE-MRI was performed immediately after UF DCE-MRI. Interrater agreements were evaluated using the intraclass correlation coefficient (ICC) and Cohen's kappa. Univariate and multivariate logistic regression analyses of the MRI parameters, lesion size, and patient age were performed to predict TNBC and create a prediction model. The programmed death-ligand 1 (PD-L1) expression statuses of the patients with TNBCs were also evaluated. RESULTS: In total, 187 women (mean age, 58 years ± 12.9 [standard deviation]) with 191 lesions (33 TNBCs) were evaluated. The ICC for MS, TTE, ADC, and lesion size were 0.95, 0.97, 0.83, and 0.99, respectively. The kappa values of rim enhancements on UF and early-phase DCE-MRI were 0.88 and 0.84, respectively. MS on UF DCE-MRI and rim enhancement on early-phase DCE-MRI remained significant parameters after multivariate analyses. The prediction model created using these significant parameters yielded an area under the curve of 0.74 (95% CI, 0.65, 0.84). The PD-L1-expressing TNBCs tended to have higher rim enhancement rates than the non-PD-L1-expressing TNBCs. CONCLUSION: A multiparametric model using UF and early-phase DCE-MRI parameters may be a potential imaging biomarker to identify TNBCs. CLINICAL RELEVANCE STATEMENT: Prediction of TNBC or non-TNBC at an early point of diagnosis is crucial for appropriate management. This study offers the potential of UF and early-phase DCE-MRI to offer a solution to this clinical issue. KEY POINTS: • It is crucial to predict TNBC at an early clinical period. • Parameters on UF DCE-MRI and early-phase conventional DCE-MRI help in predicting TNBC. • Prediction of TNBC by MRI may be useful in determining appropriate clinical management.


Assuntos
Neoplasias da Mama , Neoplasias de Mama Triplo Negativas , Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/patologia , Neoplasias de Mama Triplo Negativas/diagnóstico por imagem , Antígeno B7-H1 , Estudos Retrospectivos , Meios de Contraste/farmacologia , Imageamento por Ressonância Magnética/métodos
4.
Nanotechnology ; 34(5)2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36317307

RESUMO

Turbostratic multilayer graphene (MLG) is of great interest due to its unique electronic properties resulting from a linear band dispersion at the K point, which is similar to that of single-layer graphene. The band structure is derived from the stacking structure of turbostratic MLG where graphene layers have random in-plane rotations with respect to each other. Although wafer-scale growth of turbostratic MLG has been demonstrated, the crystallinity of individual graphene layers is still challenging to investigate. In this study, we present a new approach to reveal the grain structure of turbostratic MLG by transmission electron microscopy (TEM) observation. Mechanical delamination is demonstrated for the chemical vapor deposited MLG to peel off the topmost graphene layers by using a polydimethylsiloxane sheet. Micrometer-scale patterning of the MLG prior to the delamination is found to be effective to obtain graphene films with the designed shape and arrangement. Furthermore, the delaminated graphene films are successfully transferred onto a TEM grid, enabling us to estimate the grain size of the turbostratic MLG. This method is potentially applicable for not only preparing samples but also fabricating vertically stacked heterostructure devices using 2D materials.

5.
Cancer Sci ; 112(8): 3338-3348, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34036661

RESUMO

Predicting pathogenic germline variants (PGVs) in breast cancer patients is important for selecting optimal therapeutics and implementing risk reduction strategies. However, PGV risk factors and the performance of prediction methods in the Japanese population remain unclear. We investigated clinicopathological risk factors using the Tyrer-Cuzick (TC) breast cancer risk evaluation tool to predict BRCA PGVs in unselected Japanese breast cancer patients (n = 1,995). Eleven breast cancer susceptibility genes were analyzed using target-capture sequencing in a previous study; the PGV prevalence in BRCA1, BRCA2, and PALB2 was 0.75%, 3.1%, and 0.45%, respectively. Significant associations were found between the presence of BRCA PGVs and early disease onset, number of familial cancer cases (up to third-degree relatives), triple-negative breast cancer patients under the age of 60, and ovarian cancer history (all P < .0001). In total, 816 patients (40.9%) satisfied the National Comprehensive Cancer Network (NCCN) guidelines for recommending multigene testing. The sensitivity and specificity of the NCCN criteria for discriminating PGV carriers from noncarriers were 71.3% and 60.7%, respectively. The TC model showed good discrimination for predicting BRCA PGVs (area under the curve, 0.75; 95% confidence interval, 0.69-0.81). Furthermore, use of the TC model with an optimized cutoff of TC score ≥0.16% in addition to the NCCN guidelines improved the predictive efficiency for high-risk groups (sensitivity, 77.2%; specificity, 54.8%; about 11 genes). Given the influence of ethnic differences on prediction, we consider that further studies are warranted to elucidate the role of environmental and genetic factors for realizing precise prediction.


Assuntos
Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/genética , Proteína do Grupo de Complementação N da Anemia de Fanconi/genética , Triagem de Portadores Genéticos/métodos , Mutação em Linhagem Germinativa , Neoplasias Ovarianas/genética , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Feminino , Predisposição Genética para Doença , Humanos , Japão , Pessoa de Meia-Idade , Taxa de Mutação , Linhagem , Vigilância da População , Medição de Risco
6.
J Magn Reson Imaging ; 52(1): 70-90, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31520518

RESUMO

Diffusion-weighted imaging (DWI) is increasingly being incorporated into routine breast MRI protocols in many institutions worldwide, and there are abundant breast DWI indications ranging from lesion detection and distinguishing malignant from benign tumors to assessing prognostic biomarkers of breast cancer and predicting treatment response. DWI has the potential to serve as a noncontrast MR screening method. Beyond apparent diffusion coefficient (ADC) mapping, which is a commonly used quantitative DWI measure, advanced DWI models such as intravoxel incoherent motion (IVIM), non-Gaussian diffusion MRI, and diffusion tensor imaging (DTI) are extensively exploited in this field, allowing the characterization of tissue perfusion and architecture and improving diagnostic accuracy without the use of contrast agents. This review will give a summary of the clinical literature along with future directions. Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;52:70-90.


Assuntos
Neoplasias da Mama , Imagem de Tensor de Difusão , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Movimento (Física) , Reprodutibilidade dos Testes
7.
J Magn Reson Imaging ; 51(1): 164-174, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31215107

RESUMO

BACKGROUND: Ultrafast dynamic contrast-enhanced (UF-DCE) breast MRI is considered a promising method of accelerated breast MRI. However, the value of new kinetic parameters derived from UF-DCE need clinical evaluation. PURPOSE: To evaluate the diagnostic performance of the maximum slope (MS), time to enhancement (TTE), and time interval between arterial and venous visualization (AVI) derived from UF-DCE MRI using compressed sensing (CS). STUDY TYPE: Retrospective. POPULATION: Seventy-five patients with histologically proven breast lesions. The total number of analyzed lesions was 90 (61 malignant and 29 benign). FIELD STRENGTH/SEQUENCE: 3T MRI with UF-DCE MRI based on the 3D gradient-echo volumetric interpolated breath-hold examination (VIBE) sequence using incoherent k-space sampling combined with a CS reconstruction followed by conventional DCE MRI. ASSESSMENT: The diagnostic performance of the MS, TTE, AVI, and conventional kinetic analysis was analyzed and compared with histology. STATISTICAL TESTS: Wilcoxon rank sum test, receiver operating characteristic analysis. RESULTS: The MS was larger and the TTE and AVI were smaller for malignant lesions compared with benign lesions: MS: 29.3%/s and 18.4%/s (P < 0.001), TTE: 7.0 and 12.0 seconds (P < 0.001), AVI: 2.7 and 4.4 frames (P = 0.006) for malignant and benign lesions. The discriminating power of the MS (area under the curve [AUC], 0.76) was slightly better than that of conventional kinetic analysis (AUC, 0.69) and comparable to that of the TTE and AVI (AUC, 0.78 and 0.76 for TTE and AVI, respectively). Invasive lobular carcinoma had smaller MS (21.8%/s) among malignant lesions (29.3%/s). DATA CONCLUSION: The MS, TTE, and AVI can be used to evaluate breast lesions with clinical performance equivalent to that of conventional kinetic analysis. These parameters vary among histologies. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:164-174.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Mama/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
11.
J Magn Reson Imaging ; 50(1): 88-95, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30578563

RESUMO

BACKGROUND: There is growing interest in the effect of diffusion time on apparent diffusion coefficient (ADC) values in cancers; however, little evidence exists regarding its utility to differentiate malignant from benign head and neck tumors. PURPOSE: To investigate the utility of ADC value changes in distinguishing between malignant and benign head and neck tumors using the different diffusion times obtained from oscillating gradient spin-echo (OGSE) and pulsed gradient spin-echo (PGSE) MRI sequences. STUDY TYPE: Prospective. SUBJECTS: Thirty-one consecutive patients with suspected head and neck tumors and a phantom. FIELD STRENGTH/SEQUENCE: 3T MRI with diffusion-weighted imaging (DWI) using OGSE (effective diffusion time: 4.3 msec) and PGSE (effective diffusion time: 82.6 msec) sequences and b-values of 0 and 700 s/mm2 . ASSESSMENT: ADC values using OGSE (ADCOGSE ) and PGSE (ADCPGSE ) and relative ADC value changes between ADCOGSE and ADCPGSE . STATISTICAL TESTS: Wilcoxon test, Mann-Whitney test, and McNemar test. RESULTS: Relative ADC changes for each polyvinylpyrrolidone (PVP) and water in the phantom between OGSE and PGSE sequences were small (relative ADC change within 0.6%). Malignant tumors had significantly smaller ADCOGSE and ADCPGSE values than benign tumors (P < 0.001 and < 0.0001, respectively). Significantly larger relative ADC changes were observed in malignant compared with benign head and neck tumors (P < 0.0001). ADCPGSE values were significantly lower than ADCOGSE values in both malignant and benign head and neck tumors (0.97 vs. 1.28 × 10-3 mm2 /s: P < 0.0001 and 1.93 vs. 1.99 × 10-3 mm2 /s: P = 0.0056, respectively). Relative ADC change and ADCPGSE tended to have higher diagnostic performance than ADCOGSE , with area under the curve (AUC) values of 0.97, 0.96, and 0.89, respectively. DATA CONCLUSION: ADC values obtained using the PGSE sequence were lower than those obtained with OGSE. This difference was larger for malignant than benign tumors, suggesting differences in tissue structure (diffusion hindrance) or cell permeability, revealed by changes in diffusion time. The results underline the potential importance of reporting diffusion time for interpretation of head and neck diffusion MRI. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:88-95.


Assuntos
Diagnóstico por Computador , Imagem de Difusão por Ressonância Magnética , Imagem Ecoplanar , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artefatos , Carcinoma de Células Escamosas/diagnóstico por imagem , Criança , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Imageamento Tridimensional , Masculino , Neoplasias Maxilares/diagnóstico por imagem , Pessoa de Meia-Idade , Movimento (Física) , Distribuição Normal , Papiloma/diagnóstico por imagem , Permeabilidade , Imagens de Fantasmas , Estudos Prospectivos , Curva ROC , Fatores de Tempo , Adulto Jovem
13.
Radiology ; 306(2): e222129, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36125381
15.
Radiology ; 287(2): 432-441, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29095673

RESUMO

Purpose To investigate the performance of integrated approaches that combined intravoxel incoherent motion (IVIM) and non-Gaussian diffusion parameters compared with the Breast Imaging and Reporting Data System (BI-RADS) to establish multiparameter thresholds scores or probabilities by using Bayesian analysis to distinguish malignant from benign breast lesions and their correlation with molecular prognostic factors. Materials and Methods Between May 2013 and March 2015, 411 patients were prospectively enrolled and 199 patients (allocated to training [n = 99] and validation [n = 100] sets) were included in this study. IVIM parameters (flowing blood volume fraction [fIVIM] and pseudodiffusion coefficient [D*]) and non-Gaussian diffusion parameters (theoretical apparent diffusion coefficient [ADC] at b value of 0 sec/mm2 [ADC0] and kurtosis [K]) by using IVIM and kurtosis models were estimated from diffusion-weighted image series (16 b values up to 2500 sec/mm2), as well as a synthetic ADC (sADC) calculated by using b values of 200 and 1500 (sADC200-1500) and a standard ADC calculated by using b values of 0 and 800 sec/mm2 (ADC0-800). The performance of two diagnostic approaches (combined parameter thresholds and Bayesian analysis) combining IVIM and diffusion parameters was evaluated and compared with BI-RADS performance. The Mann-Whitney U test and a nonparametric multiple comparison test were used to compare their performance to determine benignity or malignancy and as molecular prognostic biomarkers and subtypes of breast cancer. Results Significant differences were found between malignant and benign breast lesions for IVIM and non-Gaussian diffusion parameters (ADC0, K, fIVIM, fIVIM · D*, sADC200-1500, and ADC0-800; P < .05). Sensitivity and specificity for the validation set by radiologists A and B were as follows: sensitivity, 94.7% and 89.5%, and specificity, 75.0% and 79.2% for sADC200-1500, respectively; sensitivity, 94.7% and 96.1%, and specificity, 75.0% and 66.7%, for the combined thresholds approach, respectively; sensitivity, 92.1% and 92.1%, and specificity, 83.3% and 66.7%, for Bayesian analysis, respectively; and sensitivity and specificity, 100% and 79.2%, for BI-RADS, respectively. The significant difference in values of sADC200-1500 in progesterone receptor status (P = .002) was noted. sADC200-1500 was significantly different between histologic subtypes (P = .006). Conclusion Approaches that combined various IVIM and non-Gaussian diffusion MR imaging parameters may provide BI-RADS-equivalent scores almost comparable to BI-RADS categories without the use of contrast agents. Non-Gaussian diffusion parameters also differed by biologic prognostic factors. © RSNA, 2017 Online supplemental material is available for this article.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Mama/diagnóstico por imagem , Mama/patologia , Imagem de Difusão por Ressonância Magnética , Aumento da Imagem , Interpretação de Imagem Assistida por Computador/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Aumento da Imagem/instrumentação , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
16.
J Magn Reson Imaging ; 47(1): 97-104, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28556576

RESUMO

PURPOSE: To evaluate the feasibility of ultrafast dynamic contrast-enhanced (UF-DCE) magnetic resonance imaging (MRI) with compressed sensing (CS) for the separate identification of breast arteries/veins and perform temporal evaluations of breast arteries and veins with a focus on the association with ipsilateral cancers. MATERIALS AND METHODS: Our Institutional Review Board approved this study with retrospective design. Twenty-five female patients who underwent UF-DCE MRI at 3T were included. UF-DCE MRI consisting of 20 continuous frames was acquired using a prototype 3D gradient-echo volumetric interpolated breath-hold sequence including a CS reconstruction: temporal resolution, 3.65 sec/frame; spatial resolution, 0.9 × 1.3 × 2.5 mm. Two readers analyzed 19 maximum intensity projection images reconstructed from subtracted images, separately identified breast arteries/veins and the earliest frame in which they were respectively visualized, and calculated the time interval between arterial and venous visualization (A-V interval) for each breast. RESULTS: In total, 49 breasts including 31 lesions (breast cancer, 16; benign lesion, 15) were identified. In 39 of the 49 breasts (breasts with cancers, 16; breasts with benign lesions, 10; breasts with no lesions, 13), both breast arteries and veins were separately identified. The A-V intervals for breasts with cancers were significantly shorter than those for breasts with benign lesions (P = 0.043) and no lesions (P = 0.007). CONCLUSION: UF-DCE MRI using CS enables the separate identification of breast arteries/veins. Temporal evaluations calculating the time interval between arterial and venous visualization might be helpful in the differentiation of ipsilateral breast cancers from benign lesions. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:97-104.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/irrigação sanguínea , Meios de Contraste/química , Imageamento por Ressonância Magnética , Adulto , Idoso , Artérias/patologia , Neoplasias da Mama/irrigação sanguínea , Compressão de Dados , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Veias/patologia
17.
Eur Radiol ; 28(8): 3194-3203, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29460074

RESUMO

OBJECTIVES: To compare breast density measured on digital breast tomosynthesis (DBT) (BI-RADS-based breast composition and fully-automatic estimation) and magnetic resonance imaging (MRI) (BI-RADS amount of fibroglandular tissue), and to evaluate the diagnostic performance in terms of sensitivity and specificity of DBT and MRI in a predominantly dense breast population. METHODS: Between 2015 and 2016, 152 women with 103 breast malignancies, who underwent 3-T breast MRI and DBT within 2 months' time, were enrolled in this study. Breast composition/fibroglandular tissue and findings on DBT (two readers) and MRI were reported using BI-RADS 5th edition. Digital mammography images were analysed for breast percent density (PD) using the Libra software tool. RESULTS: A majority of women had dense breasts as categorised by breast composition c (heterogeneously dense) (68%) and d (extremely dense) (15%). The mean PD was 44% (range, 18-89%) and the correlation between breast composition and PD was r = 0.6. The diagnostic performance of MRI was significantly higher compared to DBT for one reader as described by the area under the receiver operating characteristic (ROC) curve (p = 0.004) and of borderline significance for the other reader (p = 0.052). CONCLUSIONS: MRI had higher diagnostic performance than DBT in a dense breast population in the tertiary setting. KEY POINTS: • MRI had higher diagnostic performance than DBT in a dense breast population • Diagnostic performance of DBT was comparable to MRI in women with fatty breasts • MRI was superior to DBT in preoperative breast cancer size assessment.


Assuntos
Neoplasias da Mama/patologia , Mamografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/patologia , Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Curva ROC , Sensibilidade e Especificidade , Software
19.
J Magn Reson Imaging ; 45(2): 617-623, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27417879

RESUMO

PURPOSE: To investigate the influence of lactation and ovarian hormones on uterine morphology and function by comparing uteruses of lactating women with nulliparous women on MRI. MATERIALS AND METHODS: Sagittal T2WI and cine MR images were obtained with 1.5 Tesla (T) and 3T scanner from 22 lactating women and 16 nulliparous women as a control group. The lactating group was further divided into amenorrhea and menorrhea subgroups. Uterine area, endometrial thickness, junctional zone (JZ) thickness, relative signal intensity (rSI) of the JZ, and of the outer myometrium (OM), were measured on T2-weighted fast spin echo images as static image parameters. Frequency of peristalsis (/3min), degree of endometrial transformation, subendometrial conduction, outer myometrial (OM) conduction, and sporadic myometrial contraction were evaluated using cine MR images. The above image parameters were compared between the lactating group and the control group, and between the lactational amenorrhea group and the lactational menorrhea group as a sub-analysis. RESULTS: A significant difference was observed in all the static image parameters and in three of the five cine image parameters between the lactating group and the control group (P < 0.01). In sub-analysis, a statistical significance was found between the lactational amenorrhea group and lactational menorrhea group in area of the uterus and both endometrial and JZ thickness (P < 0.05), but not in cine image parameters (P = 0.682, P = 0.096, P = 0.191, P = 0.939, P = 0.289, respectively). CONCLUSION: Uterine appearance and peristalsis were different between lactating and nulliparous women. The morphological differences were pronounced between lactating amenorrhea and menorrhea women. LEVEL OF EVIDENCE: 2 J. Magn. Reson. Imaging 2017;45:617-623.


Assuntos
Hormônios Esteroides Gonadais/metabolismo , Lactação/fisiologia , Imageamento por Ressonância Magnética/métodos , Ovário/metabolismo , Peristaltismo/fisiologia , Útero/anatomia & histologia , Útero/fisiologia , Adulto , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Útero/diagnóstico por imagem
20.
Acta Radiol ; 58(2): 224-231, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27055921

RESUMO

Background Although age-related change of junctional zone (JZ) of the uterus has been known, there has been no previous systematic study of age-related changes of uterine peristalsis that is observed as the wave conduction of the thickest or darkest area within the JZ. Purpose To examine the age-related changes of uterine peristalsis in pre and postmenopausal women using cine magnetic resonance imaging (MRI), and to determine the correlation between peristalsis and JZ on T2-weighted (T2W) imaging. Material and Methods Cine MRI analysis was performed in 64 premenopausal volunteers and in 43 postmenopausal women. The peristaltic frequency, JZ detectability, and JZ thickness were evaluated and compared between the two groups. In the premenopausal group, the correlations between age and each item was examined. In the postmenopausal group, the number of years after menopause was used instead of age. The correlation between peristaltic frequency and JZ detectability or thickness was also analyzed. Results Peristaltic frequency and JZ detectability significantly differed between the two groups, while JZ thickness did not. Peristaltic frequency did not vary significantly with age before menopause and no peristalsis was observed after menopause. JZ detectability did not change significantly with age or number of years after menopause, while JZ thickness significantly increased with age before menopause, but did not vary after menopause. A significant moderate correlation was observed between JZ detectability and peristaltic frequency, but not between JZ thickness and peristaltic frequency. Conclusion Uterine peristalsis frequency did not change significantly according to age, but observed peristalsis on MRI significantly decreased after menopause.


Assuntos
Imagem Cinética por Ressonância Magnética , Peristaltismo/fisiologia , Pós-Menopausa/fisiologia , Contração Uterina/fisiologia , Adulto , Fatores Etários , Idoso , Envelhecimento , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Útero/diagnóstico por imagem , Útero/fisiologia , Adulto Jovem
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