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Our study was to investigate the feasibility of intravoxel incoherent motion (IVIM) MR imaging in the detection of endometrial fibrosis in patients with intrauterine injury. 30 patients with hysteroscopy-confirmed endometrial fibrosis and 28 healthy women were enrolled to undergo MR examination including the IVIM sequence. Endometrial thickness (ET); apparent diffusion coefficient (ADC); and IVIM parameters, including pure diffusion coefficient (<jats:italic>D<\/jats:italic>), pseudodiffusion coefficient (<jats:italic>D*<\/jats:italic>) and vascular fraction (<jats:italic>f<\/jats:italic>) were evaluated. A multivariable model combing ADC, <jats:italic>D<\/jats:italic>, and <jats:italic>f<\/jats:italic> values using binary logistic regression analysis was built to diagnose endometrial fibrosis. Endometrial fibrosis patients demonstrated lower endometrial ADC, <jats:italic>D<\/jats:italic>, <jats:italic>f<\/jats:italic> values and ET (all p\u2009&lt;\u20090.05). The multivariable model, ADC, <jats:italic>D<\/jats:italic>, <jats:italic>f<\/jats:italic> values and ET performed well in diagnosing endometrial fibrosis with AUC of 0.979, 0.965, 0.920, 0.901 and 0.833, respectively<jats:italic>.<\/jats:italic> The multivariable model revealed a better diagnostic accuracy than <jats:italic>D<\/jats:italic>, <jats:italic>f<\/jats:italic> and ET (all p\u2009&lt;\u20090.05). Although ADC achieved a better diagnostic value than ET (z\u2009=\u20092.082, p\u2009&lt;\u20090.05), no difference in AUC was shown among ADC, <jats:italic>D<\/jats:italic>, and <jats:italic>f<\/jats:italic> (all p\u2009&gt;\u20090.05); between ET and <jats:italic>D<\/jats:italic> (p\u2009&gt;\u20090.05); and between ET and <jats:italic>f<\/jats:italic> (p\u2009&gt;\u20090.05). The reproducibility of ADC, <jats:italic>D<\/jats:italic>, <jats:italic>f<\/jats:italic> and <jats:italic>D*<\/jats:italic> values in patients with endometrial fibrosis and healthy women were good to excellent (ICC: 0.614\u20130.951). IVIM parameters exhibit promising potential to serve as imaging biomarkers in the noninvasive assessment of endometrial fibrosis.<\/jats:p>","DOI":"10.1038\/s41598-021-92383-w","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T10:03:33Z","timestamp":1624010613000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Noninvasive assessment of endometrial fibrosis in patients with intravoxel incoherent motion MR imaging"],"prefix":"10.1038","volume":"11","author":[{"given":"Qing","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peipei","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjing","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weibo","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengyang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,18]]},"reference":[{"key":"92383_CR1","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.jmig.2010.04.016","volume":"17","author":"R Deans","year":"2010","unstructured":"Deans, R. & Abbott, J. 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