Effect of uterine position and intrapelvic motions on the image quality of 3D T2-weighted MRI of the uterus: Can short prescans predict the non-diagnostic image quality?

Abstract

PurposeTo evaluate prescan findings of uterine position and intrapelvic motions that predict the non-diagnostic image quality of three-dimensional T2-weighted MRI (3D-T2WI) of the uterus. MethodsThis retrospective study included 287 women who underwent pelvic MRI including 3D-T2WI and short prescans consisting of 2D-T2WI and cine imaging. One radiologist classified 3D-T2WI of the uterus as being of diagnostic or non-diagnostic image quality and evaluated the prescans regarding uterine position and intrapelvic motions. Multivariate logistic regression analysis was performed to identify predictors of non-diagnostic 3D-T2WI. The predictive ability of the prescans was verified by two independent MRI technologists. ResultsNon-diagnostic 3D T2WI was found in 42 patients (14.6 %) and was significantly associated with severe motions of urinary flow in the bladder (p < 0.001), small bowel (p = 0.039), and respiration (p < 0.001). In the multivariate analysis of uterine position and intrapelvic motions, risk factors for the non-diagnostic image quality were prominent urinary flow when the uterus contacted the bladder (p < 0.001, adjusted odds ratio = 35.1) and severe respiratory and small bowel motions when the uterus was surrounded by the bowel (p < 0.001, adjusted odds ratio = 68.4). No risk factors were found for the uterus contacting the vertebrae. With these predictors, the prescans demonstrated a sensitivity of 82.9 and 68.3 %, and specificity of 88.2 and 93.9 % for the non-diagnostic 3D-T2WI by the two technologists, respectively. ConclusionIntrapelvic motions have a different effect on the image quality of 3D-T2WI depending on the uterine position, and short prescans may be useful in predicting time-consuming non-diagnostic 3D-T2WI of the uterus.