A Prospective Dual-Modality Tool for Monitoring Uterine Peristalsis: Integrating Dynamic MRI and Electrohysterography
摘要
This paper presents a first step towards a novel approach that combines simultaneous transabdominal electromyography (EMG) with dynamic echo-planar imaging multi-echo gradient-echo (EPI-MEGE) magnetic resonance imaging (MRI) for monitoring uterine peristaltic motion. Uterine peristalsis (UP) influences crucial processes such as menstruation, sperm transport, and embryo implantation. Current monitoring methods focus only on mechanical or electrical activity, making comparing and extrapolating results between different modalities difficult. The proposed protocol combines dynamic EPI-MEGE MRI and transabdominal EMG to capture the anatomical and electrophysiological features of UP simultaneously. Electrohysterographic (EHG) signals obtained from recorded EMG supported the spatiotemporal information of MRI by integrating the synchronized electrical activity of uterine muscles. Safety testing in a phantom confirmed that the electrode temperature during EPI-MEGE MRI acquisition remained within acceptable limits for human application. Three healthy volunteers underwent EPI-MEGE MRI acquisition with simultaneous transabdominal EMG. Electrode placement strategies proved to be reproducible and anatomically consistent. MRI frames enabled the visualization of the uterus anatomy and contractions, while bowel gas affected the spatial resolution, and the bladder filling influenced the uterus positioning over time. Results showed the feasibility of a non-invasive and simultaneous method for assessing uterine contractility, combining dynamic MRI scans with synchronized EHG.