Federica Fiocchi, Presenter: Nothing to Disclose

Elena Siopis MD, Abstract Co-Author: Nothing to Disclose

Luca Nocetti PhD, Abstract Co-Author: Nothing to Disclose

Serena Currà MD, Abstract Co-Author: Nothing to Disclose

Guido Ligabue MD, Abstract Co-Author: Nothing to Disclose

Pietro Torricelli MD, Abstract Co-Author: Nothing to Disclose

To investigate fibre architecture of in-vivo human uterus by 3T MR-DTI with 3D tractography approach.Fibres orientation of non-pregnant volunteers were compared to fibres in uteri having had caesarean sections as there is higher incidence of placenta previa-accreta in patients with uterine scars. Quantitative results regarding fibres number, density, Fractional anisotropy (FA) and Apparent Diffusion Coefficient (ADC) are proposed.

In vivo 3T MR-DTI was performed in 30 volunteers (14 nulliparous, 7 vaginal and 9 caesarean deliveries; mean age 37,8±13,9y/o). Main diffusion directions reflecting fibres orientation were determined using a sense-single-shot echo-planar sequence with diffusion-sensitized gradients (b=600 mm2/s) along 16-32 directions. A fibre-tracking algorithm was used to depict fibres architecture which was compared to histological slides of cadaveric uteri. Global and regional fibres number, density, FA and ADC were measured in 13 volunteers (8 nulliparous, 5 caesarean deliveries).

MR-DTI showed two main systems of fiber: one running circularly and the other longitudinally around uterine cavity reflecting anatomical distribution as proved ex-vivo. Anisotropy was found in most regions of non-scarred uteri (21 volunteers: 14 nulliparous, 7 multiparous), but preferential fibers order could be depicted. Two third of uteri with caesarean scar (6/9) had altered structure compared to normal uteri in suture zone. Numeric data of 13 volunteers (8 nulliparous -I group-, 5 with caesarean delivery- II group) showed lowest regional fiber number and density in anterior isthmus (respectively 105, 77 and 9.3, 6.7), site of suture, especially in two volunteers with deeply disrupting scar that had placental complication at subsequent delivery. Regarding whole uterus mean FA and ADC were respectively 0.4±0.0 and 3.4±0.4x10-3 mm2/s. ADC was higher in group I respect to group II, although not statistically significant.

3T MR-DTI shows in-vivo human uterus fibers architecture and highlights the irregular pattern of caesarean scars which may be related to subsequent occurence of placental complications. Numeric data are preliminary result that may help in differentiate less to more destroying scar.

3T MR-DTI can help to have an in-vivo insight of uterine anatomy noninvasively, especially in women with previous caesarean surgery in order to have better management of future deliveries.

Fiocchi, F, Siopis, E, Nocetti, L, Currà, S, Ligabue, G, Torricelli, P, In Vivo 3 T Magnetic Resonance (MR) Diffusion Tensor Imaging (DTI) for Depicting Fibre Architecture of Human Uterus: A Feasibility and Quantitative Study.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11001136.html