Junctional zone thickness in young nulliparous women according to menstrual cycle and hormonal contraception use

Abstract

This prospective study aims to determine the optimal menstrual phase and uterine location to detect the thickest junctional zone by magnetic resonance imaging (MRI). Healthy nulliparous women were subdivided according to their use of hormonal contraception. Each women was investigated three times during their menstrual cycle. Eighteen nulliparous non-users and 29 nulliparous users of hormonal contraception (mean age 26.4 and 25.8 years, respectively) underwent a pelvic MRI (1.5T) examination during the follicular, ovulatory and luteal phase. The junctional zone thickness was measured at six locations in the uterine wall. A significantly thinner junctional zone was observed at the anterior and posterior wall of the midcorpus (P = 0.01 and P = 0.004 respectively) and fundus (P = 0.009 and P = 0.023 respectively), in the contraception users compared with the non-users. No differences in junctional zone thickness were noticed between the menstrual phases and the uterine wall locations. The ratio of junctional zone versus total myometrial thickness was also different between both groups and between the assessed uterine locations. To conclude, any phase in the menstrual cycle and location within the uterine wall was validated to determine the junctional zone thickness on MRI, although the fundal location is preferred.

Comparison of Three Methods for Estimating Volume of the Uterine Layers in Healthy Women: A Stereological Study

“…In several studies, the thickness measurement was performed to assess the junctional zone or the endometrium. For example, the thickness of junctional zone over 12 mm and the ratio of junctional zone thickness versus total myometrial thickness over the 40 % have been used as criteria for the diagnosis of adenomyosis (Kido et al, 2007;Sofic et al;Meylaerts et al). Moreover, the thickness measurement is performed on the any point on both the anterior or posterior uterine wall, and there is no standard measuring point on the uterine wall (Kido et al, 2007;Exacoustos et al;He et al).…”

“…In general, while the thickness of junctional zone is over 12 mm in adenomyosis, the thickness of less than 10 mm for endometrium is accepted normal in reproductive age women (Novellas et al, 2011;Sofic et al, 2016). Nevertheless, the thickness measurement is performed on the any point on both the anterior or posterior uterine wall and there is no standard measuring point on the uterine wall (Kido et al, 2007;Exacoustos et al, 2011;He et al;Meylaerts et al, 2017). used to evaluate genitourinary pathologies, it has limitations in displaying tissue characteristics and accurate visualization of the uterus (Hauth et al; Wasnik et al; He et al).…”

Modern possibilities for the diagnosis of adenomyosis

“…в исследовании с использованием МрТ авторы обнаружили участок с низким эхосигналом между эндометрием и миометрием. Это явление впоследствии назвали переходной зоной (junctional zone -JZ) [22,[25][26][27][28]. в патогенезе аденомиоза переходная зона играет значимую роль.…”

“…в патогенезе аденомиоза переходная зона играет значимую роль. в норме толщина ее составляет от 2,0 до 5,0 мм [29], изменяется в различные периоды жизни и под действием различных препаратов [25].…”

“…еще в 1999 г. c. reinhold et al установили, что аденомиоз диагностируется при толщине переходной зоны 12 мм и более [3]. Кроме того, толщина JZ увеличена в области дна матки по сравнению со стенками [25]. При исследовании сокращений JZ в неизменной матке и при аденомиозе в различные фазы менструального цикла выявлены достоверные отличия в амплитуде, частоте и направлении сокращений [31].…”