Uterine Peristalsis Before and After Ultrasound-Guided High-Intensify Focused Ultrasound (USgHIFU) Treatment for Symptomatic Uterine Fibroids.

BACKGROUND This study investigated uterine peristalsis before and after ultrasound-guided high-intensify focused ultrasound (USgHIFU) treatment for symptomatic uterine fibroids by cine magnetic resonance imaging (cine MRI). MATERIAL AND METHODS A total of 30 patients with symptomatic uterine fibroids were treated by USgHIFU, who were subjected to cine MRI before and after USgHIFU treatment in the periovulatory phase. The images were analyzed for the existence, direction, and frequency of uterine peristalsis. The effects of uterine volume, the largest fibroid volume and location, and the fibroid number were examined before and after USgHIFU treatment. RESULTS The incidence of uterine peristalsis was significantly increased after USgHIFU treatment. The main direction of uterine peristalsis before and after USgHIFU was cervix-to-fundus. In 12 cases, uterine peristalsis newly emerged after USgHIFU, and the largest fibroid volumes in these 12 cases were significantly smaller than in the remaining 18 cases before and after USgHIFU. The reduction rates of the largest fibroid volume in the 12 cases were significantly higher than in the remaining 18 cases. The largest fibroids were mainly located in the intramural area before and after USgHIFU. CONCLUSIONS USgHIFU treatment may contribute to the recovery of uterine peristalsis in patients with symptomatic fibroids, as detected by cine MRI. Uterine peristalsis recovery was related to the largest fibroid volume, especially for intramural fibroids.

Total sleep deprivation alters spontaneous brain activity in medical staff during routine clinical work: a resting-state functional MR imaging study.

Objectives: To assess the effect of total sleep deprivation (TSD) on spontaneous brain activity in medical staff during routine clinical practice. Methods: A total of 36 medical staff members underwent resting-state functional MRI (rs-fMRI) scans and neuropsychological tests twice, corresponding to rested wakefulness (RW) after normal sleep and 24 h of acute TSD. The rs-fMRI features, including the mean fractional amplitude of low-frequency fluctuation (mfALFF), z-score transformed regional homogeneity (zReHo), and functional connectivity (zFC), were compared between RW and TSD. Correlation coefficients between the change in altered rs-fMRI features and the change in altered scores of neuropsychological tests after TSD were calculated. Receiver operating characteristic (ROC) and logistic regression analyses were performed to evaluate the diagnostic efficacy of significantly altered rs-fMRI features in distinguishing between RW and TSD states. Results: Brain regions, including right superior temporal gyrus, bilateral postcentral gyrus, left medial superior frontal gyrus, left middle temporal gyrus, right precentral gyrus, and left precuneus, showed significantly enhanced rs-fMRI features (mfALFF, zReHo, zFC) after TSD. Moreover, the changes in altered rs-fMRI features of the right superior temporal gyrus, bilateral postcentral gyrus, left middle temporal gyrus, and left precuneus were significantly correlated with the changes in several altered scores of neuropsychological tests. The combination of mfALFF (bilateral postcentral gyrus) and zFC (left medial superior frontal gyrus and left precuneus) showed the highest area under the curve (0.870) in distinguishing RW from TSD. Conclusion: Spontaneous brain activity alterations occurred after TSD in routine clinical practice, which might explain the reduced performances of these participants in neurocognitive tests after TSD. These alterations might be potential imaging biomarkers for assessing the impact of TSD and distinguishing between RW and TSD states.