Adenomyosis: prospective comparison of MR imaging and transvaginal sonography.

Ascher, Susan M.; Arnold, Lori L.; Patt, Richard H.; Schruefer, John J.; Bagley, Ann S.; Semelka, Richard C.; Zeman, Robert K.; Simon, James A.

doi:10.1148/radiology.190.3.8115630

Cited by 251 publications

(159 citation statements)

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“…Ultrasound or magnetic resonance imaging (MRI) may aid in the nonsurgical diagnosis of adenomyosis, with MRI having 78-88% sensitivity and 67-93% specificity (Ascher et al 1994, Reinhold et al 1996, Atri et al 2000, Dueholm et al 2001, Bazot et al 2001.…”

Section: Introductionmentioning

confidence: 99%

Metformin inhibits growth of eutopic stromal cells from adenomyotic endometrium via AMPK activation and subsequent inhibition of AKT phosphorylation: a possible role in the treatment of adenomyosis

et al. 2013

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Adenomyosis is a finding that is associated with dysmenorrhea and heavy menstrual bleeding, associated with PI3K/AKT signaling overactivity. To investigate the effect of metformin on the growth of eutopic endometrial stromal cells (ESCs) from patients with adenomyosis and to explore the involvement of AMP-activated protein kinase (AMPK) and PI3K/AKT pathways. Primary cultures of human ESCs were derived from normal endometrium (normal endometrial stromal cells (N-ESCs)) and adenomyotic eutopic endometrium (adenomyotic endometrial stroma cells (A-ESCs)). Expression of AMPK was determined using immunocytochemistry and western blot analysis. 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assays were used to determine the effects of metformin and compound C on ESCs and also to detect growth and proliferation of ESCs. AMPK and PI3K/AKT signaling was determined by western blotting. A-ECSs exhibited greater AMPK expression than N-ESCs. Metformin inhibited proliferation of ESCs in a concentration-dependent manner. The IC 50 was 2.45 mmol/l for A-ESCs and 7.87 mmol/l for N-ESCs. Metformin increased AMPK activation levels (p-AMPK/AMPK) by 2.0G0.3-fold in A-ESCs, 2.3-fold in A-ESCs from the secretory phase, and 1.6-fold in the proliferation phase. The average reduction ratio of 17b-estradiol on A-ESCs was 2.1G0.8-fold in proliferative phase and 2.5G0.5-fold in secretory phase relative to the equivalent groups not treated with 17b-estradiol. The inhibitory effects of metformin on AKT activation (p-AKT/AKT) were more pronounced in A-ESCs from the secretory phase (3.2-fold inhibition vs control) than in those from the proliferation phase (2.3-fold inhibition vs control). Compound C, a selective AMPK inhibitor, abolished the effects of metformin on cell growth and PI3K/AKT signaling. Metformin inhibits cell growth via AMPK activation and subsequent inhibition of PI3K/AKT signaling in A-ESCs, particularly during the secretory phase, suggesting a greater effect of metformin on A-ESCs from secretory phase.

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Section: Introductionmentioning

confidence: 99%

Metformin inhibits growth of eutopic stromal cells from adenomyotic endometrium via AMPK activation and subsequent inhibition of AKT phosphorylation: a possible role in the treatment of adenomyosis

et al. 2013

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“…Ultrasonography has been the traditional imaging modality used to assess women with symptomatic fibroids, but this modality has a limited ability to detect coexistent uterine or pelvic pathology, and it typically does not identify infarcted fibroids following UAE. MRI has a high accuracy for distinguishing between fibroids and other uterine diseases such as adenomyosis, and it also has ability to characterize infarcted fibroids and to measure the uterine and fibroid volumes more accurately (23,24). In terms of embolic agents, PVA particles and calibrated microspheres are currently widely used.…”

Section: Discussionmentioning

confidence: 99%

Uterine Artery Embolization for the Treatment of Symptomatic Fibroids

Kim

et al. 2005

J Korean Radiol Soc

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Uterine fibroids are the most common solid tumors of the female genital tract, and they develop in 20 40% of women of childbearing age (1). Although not all the women with fibroids exhibit symptoms, approximately 10 20% of women with fibroids have symptoms that negatively affect their quality of life (2). Menorrhagia, which often leads to iron-deficiency anemia, and pain during menstruation are the most common complications of uterine leiomyoma. The therapeutic options for the treatment of fibroids include hysterectomy, myomectomy, gonadotropin-releasing hormone agonists and a number of experimental ablative techniques involving energy sources such as focused ultrasound or radiofrequency ablation. Uterine artery embolization Purpose: The aim of this study was to determine the potential usefulness of uterine artery embolization (UAE) for the management of uterine leiomyoma. Materials and Methods: Sixty nine patients (mean age; 40.3 years, age range; 31 52 years) who underwent UAE for symptomatic fibroids (with menorrhagia, dysmenorrhea and bulk-related symptoms) from January 2000 to December 2000 were retrospectively analyzed. The mean follow-up period was 3.5 months (range: 1 8 months).The fibroids ranged in size from 2.0 cm to 13.2 cm with a mean size of 5.8 cm. We performed embolization using polyvinyl alcohol particles (250 710 m). The improvement of the clinical symptoms was analyzed. Reduction of the uterine and predominant fibroid volumes was assessed using MRI. Results: Symptom improvement for the menorrhagia (87.5%), dysmenorrhea (83.3%) and the bulk-related symptoms (79.2%) was reported. Complications included ovarian failure in four patients (5.8% of the total patients, mean age: 43.3 yrs) and infection in three patients (4.3% of the total patients) who underwent conservative management with intravenous antibiotics and analgesics. The volume reduction rate of the uterus and the predominant fibroids after uterine artery embolization were 36.3% and 56.6%, respectively. Conclusion: UAE is a promising new treatment for symptomatic fibroids and may be a valuable alternative to hysterectomy.

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“…Transvaginal sonography is thus a cost effective, minimally invasive and readily available tool for obstetrician and gynaecologist. 8,21,[30][31][32][33][34] The ultrasound criteria used in the index study for diagnosis of cysts and endomyometrial junction blurring, of which the most sensitive parameter was blurring of endomyometrial junction (84.78%) and the most specific parameter for diagnosis came out to be presence of myometrial cysts (96.87%).…”

Section: Ultrasonographymentioning

confidence: 99%

“…The main criteria used for diagnosing adenomyosis on USG wasthe presence of heterogeneous myometrial echotexture. 31 It was thought that this represented myometrial smooth muscle hyperplasia and hypertrophy reaction due to presence of ectopic endometrial glands within the myometrium. 19,29 In the index study myometrial cysts had lowest sensitivity (6.52%) and highest specificity.…”

Section: Ultrasonographymentioning

confidence: 99%

Clinical and ultrasonological features of adenomyosis and its histopathological correlation

Gupta

Goel

Agrawal

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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Adenomyosis: prospective comparison of MR imaging and transvaginal sonography.

Abstract: MR imaging is significantly better (P < .02) than transvaginal sonography in the diagnosis of adenomyosis.

Cited by 251 publications

References 0 publications

Metformin inhibits growth of eutopic stromal cells from adenomyotic endometrium via AMPK activation and subsequent inhibition of AKT phosphorylation: a possible role in the treatment of adenomyosis

Metformin inhibits growth of eutopic stromal cells from adenomyotic endometrium via AMPK activation and subsequent inhibition of AKT phosphorylation: a possible role in the treatment of adenomyosis

Uterine Artery Embolization for the Treatment of Symptomatic Fibroids

Clinical and ultrasonological features of adenomyosis and its histopathological correlation

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