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BackgroundChronic pancreatitis (CP) can result in persistent damage to the endocrine and exocrine tissues of the pancreas. There is an unmet need for quantitative methods to evaluate CP noninvasively.PurposeTo investigate the utility of T1ρ magnetic resonance imaging (MRI) for the assessment of CP.Study TypeProspective.PopulationTwenty patients with CP and 24 healthy volunteers.Field Strength/Sequence3T MRI including T1ρ sequence (spin lock time = 0, 1, 10, 20, 40, 60 msec).AssessmentPancreatic T1ρ values and anterior–posterior (AP) diameters in the head, body, and tail were measured in all participants. Regions of interest with circle (ROIcircle) and free‐hand (ROIFH) were drawn for T1ρ value measurements.Statistical TestsMann–Whitney U‐test; Wilcoxon Signed Ranks test; receiver operating characteristic (ROC) curve; and Bland–Altman analysis.ResultsThe T1ρ values of pancreatic tail and the mean T1ρ values for ROIcircle and the T1ρ values of pancreatic tail for ROIFH in patients with CP were significantly higher than those in healthy volunteers (all P < 0.05). Pancreatic head AP diameter significantly increased, while pancreatic tail AP diameter significantly decreased in patients with CP compared with healthy volunteers (both P < 0.05). The areas under the ROC curves (AUCs) of pancreatic tail T1ρ values with ROIcircle and tail AP diameter in diagnosing CP were 0.744 and 0.798, respectively. A combination of pancreatic tail T1ρ values with ROIcircle and tail AP diameter achieved good performance for diagnosing CP (AUC = 0.838).Data ConclusionT1ρ MRI might be a potential technique for the noninvasive evaluation of CP.Level of Evidence 2Technical Efficacy Stage 2J. MAGN. RESON. IMAGING 2021;53:577–584.

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Objective: This study aimed to determine the feasibility of diffusion-weighted imaging for detecting endometrial fibrosis in patients with intrauterine injury.Methods: This prospective study included 34 patients with endometrial fibrosis and 34 healthy controls. All participants underwent T2-weighted and diffusion-weighted magnetic resonance imaging with b values of 0 and 1000 s/mm 2 during the periovulatory phase with a dominant follicle. The endometrial apparent diffusion coefficient (ADC) and uterine anatomical parameters (endometrial thickness [EMT], length of the uterine cavity [LUC], and junctional zone thickness [JZT]) were measured and compared. Performance of the uterine endometrial ADC and anatomical parameters in diagnosing endometrial fibrosis was evaluated.Results: Patients with endometrial fibrosis showed a lower endometrial ADC, lower EMT, shorter LUC, and higher JZT than did healthy controls (all, P < 0.001). Endometrial ADC value and uterine anatomical parameters showed good performance in diagnosing endometrial fibrosis, with the areas under the receiver operating characteristic curves of 0.976, 0.870, 0.883, and 0.864, respectively. The area under the curve of ADC was significantly higher than those of EMT (z = 1.973, P = 0.0485), LUC (z = 2.059, P = 0.0395), and JZT (z = 2.484, P = 0.0130). Intraobserver and interobserver agreements of endometrial ADC value measurements were excellent for both patients (intraclass correlation coefficient = 0.987 and 0.983, respectively) and healthy women (intraclass correlation coefficient = 0.986 and 0.989, respectively). Conclusions:Our preliminary results suggest that diffusion-weighted imaging has the potential to be a noninvasive imaging tool for the quantitative assessment of endometrial fibrosis.

Recently, few noninvasive methods have been reported to evaluate endometrial fibrosis. Our study was to investigate the feasibility of intravoxel incoherent motion (IVIM) MR imaging in the detection of endometrial fibrosis in patients with intrauterine injury. 30 patients with hysteroscopy-confirmed endometrial fibrosis and 28 healthy women were enrolled to undergo MR examination including the IVIM sequence. Endometrial thickness (ET); apparent diffusion coefficient (ADC); and IVIM parameters, including pure diffusion coefficient (D), pseudodiffusion coefficient (D*) and vascular fraction (f) were evaluated. A multivariable model combing ADC, D, and f values using binary logistic regression analysis was built to diagnose endometrial fibrosis. Endometrial fibrosis patients demonstrated lower endometrial ADC, D, f values and ET (all p < 0.05). The multivariable model, ADC, D, f values and ET performed well in diagnosing endometrial fibrosis with AUC of 0.979, 0.965, 0.920, 0.901 and 0.833, respectively. The multivariable model revealed a better diagnostic accuracy than D, f and ET (all p < 0.05). Although ADC achieved a better diagnostic value than ET (z = 2.082, p < 0.05), no difference in AUC was shown among ADC, D, and f (all p > 0.05); between ET and D (p > 0.05); and between ET and f (p > 0.05). The reproducibility of ADC, D, f and D* values in patients with endometrial fibrosis and healthy women were good to excellent (ICC: 0.614–0.951). IVIM parameters exhibit promising potential to serve as imaging biomarkers in the noninvasive assessment of endometrial fibrosis.