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Effect of changes in the menstrual cycle and age on the signal intensity of amide proton transfer imaging in the normal uterus: a preliminary study

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Abstract

Purpose

To analyze the effect of changes in the menstrual cycle and age on the signal intensity of amide proton transfer (APT) imaging in normal uterine structures.

Methods

Thirty-one healthy females (age: 21–50 years old) underwent regular pelvic MRI and APT sequences during their menstrual cycle. The APT values of the endometrium, myometrium, and junctional zone were measured. One-way and multi-way analyses of variance were used to analyze the data. Intraindividual difference and Pearson's correlation analyses were also conducted.

Results

The APT values of the uterine structures during the menstrual, proliferative, and secretory phases were 3.413 ± 0.682%, 4.776 ± 0.829%, and 5.218 ± 0.772% for the endometrium; 2.966 ± 0.533%, 3.597 ± 0.380%, and 4.324 ± 0.583% for the myometrium; and 1.703 ± 0.393%, 2.362 ± 0.486%, and 2.779 ± 0.528% for the junctional zone. The individual variation in the APT values of the normal uterus during the three menstrual phases was 1.1–1.7%.There were no significant differences in APT values of uterine structures with age. The APT values of the endometrium were greater than those of other structures (P < 0.05).The Pearson correlation coefficients between APT values of uterine structures and menstrual cycle were 0.686, 0.743, and 0.684, respectively.

Conclusion

The menstrual cycle had a significant effect on the APT signal intensities of the uterine structures, whereas premenopausal age had no significant effect. Changes in the uterine structures during the menstrual cycle should be considered when using APT to diagnose suspected uterine lesions.

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Abbreviations

APT:

Amide proton transfer

CEST:

Chemical exchange saturation transfer

VEGF:

Vascular endothelial growth factor

MMP:

Matrix metalloproteinases

ECM:

Extracellular matrix

TIMPs:

Tissue inhibitors of metalloproteinases

LRP-1:

Lipoprotein receptor-related protein-1

SPAIR:

Spectral attenuation with inversion recovery

TSE:

Turbo spin echo

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Acknowledgements

We thank the Kai Deng PH.D, Medical Ethics Committee of Shandong Provincial Qianfoshan Hospital, relevant MRI staff and researchers at Philips Healthcare for supporting this study.

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766# Jingshi road, 250014, Jinan, Shandong, People’s Republic of China

    Ya-qing Kong, Qian-qian Qu, Lei Ming, Zhe Wang & Kai Deng

  2. Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan, Shandong, People’s Republic of China

    Ya-qing Kong

  3. Department of Nuclear Medicine, Central Hospital Affiliated to Shandong First Medical University & Jinan Central Hospital, Jinan, Shandong, People’s Republic of China

    Xiao-tong Chi

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  1. Ya-qing Kong
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  4. Zhe Wang
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Contributions

All authors contributed to the study conception and design. XC, YK, and QQ: Methodology, YK and QQ: Formal analysis and investigation, YK and all authors Writing—original draft preparation, KD: Writing—review and editing, KD, LM, and ZW: Supervision.

Corresponding author

Correspondence to Kai Deng.

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The authors have no competing interests to declare that are relevant to the content of this article.

Research involving human and animals rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Medical Ethics Committee of Shandong Provincial Qianfoshan Hospital.

Informed consent

Informed consent was obtained from all individual participants included in the study. The authors affirm that human research participants provided informed consent for publication of the images in Figs. 2, 3, 4.

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Kong, Yq., Qu, Qq., Ming, L. et al. Effect of changes in the menstrual cycle and age on the signal intensity of amide proton transfer imaging in the normal uterus: a preliminary study. Abdom Radiol 47, 4219–4226 (2022). https://doi.org/10.1007/s00261-022-03674-3

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