Probing Ovarian Stiffness in Healthy Volunteers With <scp>3D</scp> 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.