MRI Characteristics of the Uterine Junctional Zone: From Normal to the Diagnosis of Adenomyosis

Novellas, S.; Chassang, Madleen; Delotte, J.; Toullalan, Olivier; Chevallier, A; Bouaziz, Jérôme; Chevallier, P.

doi:10.2214/ajr.10.4877

Cited by 180 publications

(141 citation statements)

References 46 publications

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“…This limitation appears to be in line with previous studies reporting that the junctional zone cannot be delineated in about 30-50 % postmenopausal women (Bazot et al, 2001;Novellas et al;He et al). To assess junctional zone, while many studies measured the ratio of junctional zone thickness, whether in healthy women or women diagnosed with adenomyosis, no previous study reported the ratio of junctional zone volume (Meylaerts et al).…”

Section: Discussionsupporting

confidence: 76%

“…The simplest and widely used measure is the thickness of the endometrium and the junctional zone for the morphological analysis of uterus on the medical images. 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).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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KARACA, S. O.; TASKIN, M. I.; KEYIK, B.Y.; SACKES, M.; OZCAN, E. & KUS, I.Comparison of three methods for estimating volume of the uterine layers in healthy women: A stereological study. Int. J. Morphol., 36(2):614-622, 2018. SUMMARY:Aim of this study is to measure the volume of the uterine layers in healthy women according to the menstrual cycle phases and to test the agreement between three methods. The study was performed with 28 healthy women. Participants were divided into three groups as follicular (n=7), luteal (n=10) and postmenopausal phase (n=11). We used the point-counting and planimetry method in MR images and the ellipsoid methods in images obtained by transvaginal ultrasonography. Spearman correlation analysis showed significant negative correlations between the volumes of uterine layers and age (p<0.01). The volumes of the total uterus, the total myometrium and the endometrium measured with planimetry and point-counting methods were significantly lower in the postmenopausal women (p<0.01). While volumes of total uterus and the total myometrium significantly lower in the postmenopausal group in measurements done using ellipsoid method, the decrease in the volume of the endometrium was not statistically significant. The Bland-Altman test results indicated an excellent agreement between point-counting and planimetry methods in the volumetric measurements. The ellipsoid method might be inadequate for determining uterine layers volume particularly the endometrium volume. The stereological methods permit unbiased and efficient estimation of volume of uterine layers in vivo examination of MRI.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…Mainly because of the difference in cell origin, the outer myometrium presents little or no dependence on hormonal stimulation, while cyclical variation of the junctional zone thickness is similar to that of the endometrium [33]. We therefore conclude that the observed stiffness variation of the myometrium (Fig.…”

Section: Discussionmentioning

confidence: 55%

In vivo high-resolution magnetic resonance elastography of the uterine corpus and cervix

et al. 2014

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“…Obscuration of the JZ has been reported as a postmenopausal change resulting from progressive dehydration and fibrous involution of the outer myometrium. 10 This might also explain the reduced recognition of the JZ in our study; the JZ remained visible in 12 of 16 premenopausal patients after chemotherapy, although the hormonal status was similar to that of a postmenopausal state. The differences in visualization of the JZ between postmenopausal women previously reported and post-chemotherapy premenopausal patients described in our study might be due to differences in the degree and duration of low hormonal levels.…”

Section: Discussionmentioning

confidence: 60%

“…1,[9][10][11][12][13][14][15] The changes observed in the MR appearance of ovaries in premenopausal patients, (i.e., decreased volume of the ovaries, intensity of ovarian tissues on T 2 -WI, and visualization of the follicles), could be explained by the ovarian toxicity induced by NACT. This toxicity might be primarily caused by the platinum-based compound.…”

Section: Discussionmentioning

confidence: 99%

MR Imaging-based Evaluation of Morphological Changes in the Uterus and Ovaries of Patients Following Neoadjuvant Chemotherapy for Cervical Cancer

et al. 2015

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Objective: We used magnetic resonance (MR) imaging and hormonal levels to evaluate the influence of chemotherapy for cervical cancer on female pelvic reproductive organs.Materials and Methods: We retrospectively evaluated 16 pre-and 11 postmenopausal patients with cervical cancer who underwent neoadjuvant chemotherapy (NACT) and radical surgery. We evaluated morphological changes in the uterus and ovaries by MR imaging both quantitatively and qualitatively, measuring the volume of the uterine body and bilateral ovaries, endometrial thickness, and signal intensity of the myometrium and bilateral ovaries and assessing visibility of the junctional zone and bilateral ovarian follicles. We compared both quantitative and qualitative factors between pre-and post-NACT. Pre-and post-NACT hormonal values of estradiol, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) of 8 patients in the premenopausal group were obtained and analyzed statistically.Results: In the premenopausal group, we observed a statistically significant decrease in all quantitative parameters as well as in the visibility of the left ovarian follicle. In the postmenopausal group, only endometrial thickness changed significantly. Premenopausal patients showed a statistically significant decrease in levels of progesterone, FSH, and LH after chemotherapy.Conclusions: MR demonstrated changes in the uterus and ovaries in premenopausal subjects who underwent chemotherapy that resembled those changes classically reported in physiological postmenopausal subjects. These changes are likely due to ovarian toxicity and secondary hormonal changes. MR imaging might be a valuable tool for obtaining information regarding chemotherapy-induced infertility.

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MRI Characteristics of the Uterine Junctional Zone: From Normal to the Diagnosis of Adenomyosis

Cited by 180 publications

References 46 publications

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

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

In vivo high-resolution magnetic resonance elastography of the uterine corpus and cervix

MR Imaging-based Evaluation of Morphological Changes in the Uterus and Ovaries of Patients Following Neoadjuvant Chemotherapy for Cervical Cancer

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