ABSTRACT
OBJECTIVE: To determine the change in apparent diffusion coefficient (ADC) of uterine fibroids following uterine fibroid embolisation (UFE), and if the ADC change correlates with either volume loss or degree of contrast enhancement post-UFE. MATERIALS AND METHODS: This study was approved by our institutional review board with waiver of consent. The pelvic MRI examinations, including diffusion-weighted MRI (DWI) using 4 b-values, of 50 consecutive patients prior to and 6 months post-UFE were analyzed. The volume, ADC and amount of enhancement were calculated for each fibroid both pre- and post-UFE. The percent residual enhancement for each fibroid was categorized as either: no (0-1%) residual enhancement or residual (>1%) enhancement. Statistical analysis compared ADC, enhancement and volume for each fibroid pre- and post-UFE using paired t-tests and Pearson correlation coefficients. RESULTS: The mean ADC of all (n=88) fibroids pre-UFE was 1.30±0.20×10(-3)mm(2)/s, and increased to 1.68±0.24×10(-3)mm(2)/s post-UFE (p<0.0001). Lower pre-UFE ADC correlated with greater ADC change post-UFE (r=-0.50; p<0.0001). There was no correlation between ADC change and volume change post-UFE (r=0.07; p=0.59). However, fibroids with no residual enhancement post-UFE had larger ADC change than those with residual enhancement (p=0.003). CONCLUSION: The ADC of fibroids rises post-UFE. ADC change post-UFE is associated with the degree of loss of enhancement and may therefore be valuable in predicting response to treatment in pre-procedural counseling.
Subject(s)
Diffusion Magnetic Resonance Imaging/methods , Embolization, Therapeutic/methods , Leiomyoma/diagnosis , Leiomyoma/therapy , Uterine Neoplasms/diagnosis , Uterine Neoplasms/therapy , Adult , Contrast Media , Female , Humans , Image Enhancement/methods , Meglumine/analogs & derivatives , Middle Aged , Organometallic Compounds , Treatment Outcome , Uterus/pathologyABSTRACT
PURPOSE: To assess the effect of parenteral butylscopolamine on magnetic resonance cholangiopancreatography (MRCP) image quality. MATERIALS AND METHODS: The 3D free-breathing respiratory-compensated MRCP images (mean acquisition time 7min) of 94 consecutive non-paired patients (47 with and 47 without 20mg intramuscular butylscopolamine) were analysed retrospectively. Two experienced abdominal radiologists scored the image quality of five predefined pancreaticobiliary ductal segments on the MRCP images in a blinded fashion in both cohorts using a 5 point validated scale, ranging from perfect visualization of the entire ductal structure to the ductal structure being not visible. Interobserver agreement was determined. RESULTS: Parenteral butylscopolamine injection significantly reduced bowel peristalsis-related artefacts of the inferior common bile duct (CBD; p=0.031) and the pancreatic duct (PD; p=0.034) for reader 1 and the inferior CBD (p=0.041) for reader 2. The difference in visualization of all remaining ductal segments, and of the overall pancreaticobiliary tree, was not statistically significant between the two cohorts. Interobserver agreement between the two readers was substantial for the superior CBD, common hepatic duct (CHD) and PD, was moderate for the inferior CBD, and was fair for the peripheral intrahepatic ducts. CONCLUSION: On free-breathing 3D MRCP images, parenteral butylscopolamine improves only the visualization of the inferior CBD and the PD. However, no significant improvement in visualization of other ductal segments was demonstrated.