Iron deposition in ovarian endometriosis evaluated by magnetic resonance imaging R2* correlates with ovarian function.

RESEARCH QUESTION: Does iron overload in patients with endometriosis affect ovarian function? Can a method be developed to visually reflect this? DESIGN: Magnetic resonance imaging (MRI) R2* was used to evaluate the correlation between iron deposition of ovarian and anti-Müllerian hormone (AMH) in patients with endometriosis. All patients underwent T2* MRI scanning. Serum AMH levels were measured preoperatively. The area of focal iron deposition, iron content of the cystic fluid and AMH levels between the endometriosis and control groups were compared using non-parametric tests. The effects of iron overload on AMH secretion in mouse ovarian granulosa cells were investigated by adding different concentrations of ferric citrate to the medium. RESULTS: A significant difference was found between endometriosis and control groups in area of iron deposition (P < 0.0001), cystic fluid iron content (P < 0.0001), R2* of lesions (P < 0.0001) and R2* of the cystic fluid (P < 0.0001). Negative correlations were found between serum AMH levels and R2* of cystic lesions in patients with endometriosis aged 18-35 years (rs = -0.6484, P < 0.0001), and between serum AMH levels and R2* of cystic fluid (rs = -0.5074, P = 0.0050). Transcription level (P < 0.0005) and secretion level (P < 0.005) of AMH significantly decreased with the increase in iron exposure. CONCLUSION: Iron deposits can impair ovarian function, which is reflected in MRI R2*. Serum AMH levels and R2* of cystic lesions or fluid in patients aged 18-35 years had a negative correlation with endometriosis. R2* can be used to reflect the changes of ovarian function caused by iron deposition.

Intravoxel incoherent motion DWI with different mathematical models in predicting rectal adenoma with and without canceration.

PURPOSE: To evaluate the clinical value of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) with mono-exponential (ME), bi-exponential (BE), and stretched-exponential (SE) models for predicting rectal adenomas with canceration. MATERIAL AND METHODS: Sixty patients with postoperative pathology-confirmed rectal adenoma (n = 31) and adenoma with canceration (n = 29) were enrolled and underwent IVIM-DWI scanning. The ME-derived apparent diffusion coefficient (ADC), BE-derived true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), SE-derived distributed diffusion coefficient (DDC), and water molecular diffusion heterogeneity index (α) were measured. The differences in each parameter between adenoma and canceration were compared. Multivariate binary logistic regression analysis was used to establish models for predicting rectal adenomas with canceration. Receiver operating characteristic curve analysis was applied to evaluate diagnostic performances of each model in terms of sensitivity, specificity, accuracy, and area under the curve (AUC). RESULTS: The AUCs of ADC, D, D*, f, DDC and α were 0.851 (95 % confidence interval, CI, 0.735-0.930), 0.895 (95 % CI, 0.789-0.960), 0.720 (95 % CI, 0.589-0.828), 0.791 (95 % CI, 0.667-0.886), 0.841 (95 % CI, 0.724-0.923) and 0.738 (95 % CI, 0.608-0.834), respectively. The AUCs of BE and SE models were 0.927 (95 % CI, 0.829-0.978) and 0.874 (95 % CI, 0.763-0.946), respectively. The AUC, sensitivity, specificity, and accuracy of the derived four values (ADC, D, f, and DDC) from the combination of three models were 0.950, 96.6 % (95 % CI, 95.3-97.6 %), 80.6 % (95 % CI, 78.0-82.9 %), and 88.3 % (95 % CI, 86.2-90.2 %), respectively. CONCLUSION: ADC can easily and effectively predict rectal adenomas with canceration. The BE model has a better combination of sensitivity and specificity for the diagnosis of rectal adenoma canceration.