Probing Ovarian Stiffness in Healthy Volunteers With 3D Magnetic Resonance Elastography.

BACKGROUND

The feasibility of multi-frequency magnetic resonance elastography (MRE) for ovarian assessment, normative stiffness values, and related influencing factors in the general population remains unclear.

PURPOSE: To evaluate ovarian MRE feasibility, preferred frequency, normative stiffness, and influencing factors in healthy individuals.

STUDY TYPE: Prospective.

SUBJECTS: About 55 healthy female volunteers (median age: 42; median body mass index (BMI): 23).

FIELD STRENGTH/SEQUENCE: 3 T; spin-echo echo-planar imaging sequence at 40, 60, and 80 Hz.

ASSESSMENT: Quality-control metrics and ovarian stiffness values (left and right) were measured for all participants. Image quality was evaluated by IQS (1-4; diagnostic images ≥ 3) and confidence percentage.

STATISTICAL TESTS: Intraclass correlation coefficient (ICC); ANOVA; multivariate linear regression; significance level, p < 0.05.

RESULTS

Quality-control metrics, including fixed-ROI average phase SD [138.63 (106.17-177.74), 127.90 (97.77-186.46), and 133.70 (92.73-185.79)] and average within-ROI phase range [605.25 (468.43-777.50), 604.00 (432.83-821.50), and 607.00 (442.00-804.80)] at 40, 60, and 80 Hz, showed no significant frequency-dependent variation (both p = 0.947), confirming no substantial vibration-induced phase artifacts. Combined with good-to-excellent reproducibility (ICCs: 0.897-0.999), these data supported the feasibility of ovarian MRE. Among tested frequencies, 60 Hz showed relatively favorable image quality, the highest IQS agreement (inter-reader/intra-reader weighted κ = 0.828-0.891/0.862-0.877). Ovarian stiffness ranges were 1.56-2.91, 2.91-3.70, and 3.10-3.89 kPa in the premenopausal, perimenopausal, and postmenopausal groups, respectively. Ovarian stiffness remained stable across menstrual-cycle phases in either ovary (left/right: p = 0.250/0.358, 0.986/0.858, 0.088/0.476, 0.249/0.448, 0.633/0.185, and 0.120/0.706). Regression analysis identified age and BMI as independent predictors of ovarian stiffness; age had a larger standardized β than BMI (0.868 vs. 0.176), as did menopausal status when replacing age (0.832 vs. 0.213).

DATA

CONCLUSIONS

About 60 Hz provided appropriate MRE images in healthy volunteers. Ovarian stiffness was influenced by menopausal status, age, and BMI.

EVIDENCE LEVEL: 2.

TECHNICAL EFFICACY: Stage 1.