Poster électronique

Anatomie structurale du muscle utérin au cours de la grossesse par tracking de fibres
O. Ami, M. Mabille, J. De Laveaucoupet, O. Picone, A. Benachi, R. Frydman, D. Musset - Clamart - France
Congrès 2010
Résumé
Objectifs
Décrire l'anatomie du muscle utérin lors de sa distension par une grossesse au cours du troisième trimestre et quantification des fibres utérines par comparaison à un utérus normal en dehors de la grossesse.
Matériels et méthodes
Cinq patientes participant à une autre étude prospective au cours d'une procédure d'interruption médicale de grossesse ont été analysées pour reconstruire par tracking de fibres l'agencement des faisceaux de fibres myométriales dans l'utérus gravide. Le tracking de fibres a étéétudié en utilisant le logiciel DTI tractography syngo (Siemens médical Systems Saint Denis, France) avec les paramètres suivants : début du tracking sur les bords du myomètre utérin, seuil d'anisotropie fractionnaire de 0,100 ; angle de tracking de 60 g ; et pas de détection de 1,5 mm. Séquence Epi Spin Echo (SE-EPI), TE = 87 ms, TR = 380 ms, b = 1000 s/mm2.
Résultats
Le myomètre présente 3 couches distinctes dont une couche concentrique interne partant du col et 2 couches plus superficielles intriquées en provenance chacune des deux cornes utérines. La quantité de fibres utérines est en moyenne augmentée par un facteur 4 comparée à la moyenne observée dans les utérus non gravides chez des femmes du même âge.
Conclusion
L'IRM avec tracking de fibres permet l'observation de l'anatomie des fibres utérines et pourrait constituer un outil d'exploration utile dans les phénomènes d'infertilité, d'accouchement prématuré ou de fausses couches.
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