Morphological and functional assessment of the uterus: "one-stop shop imaging" using a compressed-sensing accelerated, free-breathing T1-VIBE sequence.
BACKGROUND
The combination of motion-insensitive, high-temporal, and spatial resolution imaging with evaluation of quantitative perfusion has the potential to increase the diagnostic capabilities of magnetic resonance imaging (MRI) in the female pelvis.


PURPOSE
To compare a free-breathing compressed-sensing VIBE (fbVIBE) with flexible temporal resolution (range = 4.6-13.8 s) with breath-hold VIBE (bhVIBE) and to evaluate the potential value of quantifying uterine perfusion.


MATERIAL AND METHODS
A total of 70 datasets from 60 patients (bhVIBE: n = 30; fbVIBE: n = 40) were evaluated by two radiologists. Only temporally resolved reconstruction (fbVIBE) was performed on 30 of the fbVIBE datasets. For a subset (n = 10) of the fbVIBE acquisitions, a time- and motion-resolved reconstruction (mrVIBE) was evaluated. Image quality (IQ), artifacts, diagnostic confidence (DC), and delineation of uterine structures (DoS) were graded on Likert scales (IQ/DC/DoS: 1 (non-diagnostic) to 5 (perfect); artifacts: 1 (no artifacts) to 5 (severe artifacts)). A Tofts model was applied for perfusion analysis. Ktrans was obtained in the myometrium (Mm), junctional zone (Jz), and cervix (Cx).


RESULTS
The median IQ/DoS/DC scores of fbVIBE (4/5/5 κ >0.7-0.9) and bhVIBE (4/4/4; κ = 0.5-0.7; P > 0.05) were high, but Artifacts were graded low (fbVIBE/bhVIBE: 2/2; κ = 0.6/0.5; P > 0.05). Artifacts were only slightly improved by the additional motion-resolved reconstruction (fbVIBE/mrVIBE: 2/1.5; P = 0.08); fbVIBE was preferred in most cases (7/10). Significant differences of Ktrans values were found between Cx, Jz, and Mm (0.12/0.21/0.19; P < 0.05).


CONCLUSION
The fbVIBE sequence allows functional and morphological assessment of the uterus at comparable IQ to bhVIBE.
['Hausmann|Daniel|D|https://orcid.org/0000-0002-3816-3302', 'Kreul|Diana|D|', 'Klarhöfer|Markus|M|', 'Nickel|Dominik|D|', 'Grimm|Robert|R|', 'Kiefer|Berthold|B|https://orcid.org/0000-0003-1406-8033', 'Riffel|Philipp|P|', 'Attenberger|Ulrike I|UI|', 'Zöllner|Frank G|FG|', 'Kubik-Huch|Rahel A|RA|https://orcid.org/0000-0002-3636-8697']
D000328:Adult D016477:Artifacts D005260:Female D006801:Humans D007091:Image Processing, Computer-Assisted D008279:Magnetic Resonance Imaging D008875:Middle Aged D012119:Respiration D014591:Uterine Diseases D014599:Uterus
uterus Magnetic resonance imaging female artifacts cervix uteri magnetic resonance perfusion