Transient uterine contractions as a potential pathology mimic on premenopausal pelvic <scp>MRI</scp> and the role of routine repeat T2 sagittal images to improve observer confidence

Lam, John Ym; Voyvodic, Frank; Jenkins, Melissa; Knox, Steven J.

doi:10.1111/1754-9485.12760

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…The ADC was higher in the luteal phase and lower in the ovulatory or menstrual phase 40,45,46 , and a moderate correlation was found between APT signal intensity and ADC in the JZ, which could be a result of increased cell proliferation in the secretory phase and increased peristalsis in the menstrual phase 40 . Peristalsis of the JZ is recognized on cine-MRI as a wave-like pattern and can mimic uterine pathologies such as adenomyosis and leiomyomas 68 . A positive correlation between the detectability of the JZ and the frequency of peristalsis was found, but not between JZ thickness and frequency of peristalsis 47,48 .…”

Section: Jz Indistinct or Invisible Ex Vivomentioning

confidence: 99%

“…On blood-oxygenation-level-dependent (BOLD) MRI, a lower signal was seen in the JZ during the menstrual phase than in other phases of the menstrual cycle 49 . This could be due to vascular spasms of the spiral arteries inducing menstruation 49 , or due to contraction of SMCs in the JZ during peristalsis 68 . Age and hormone medication were also found to influence the thickness and ADC value of the JZ 45,48,50 .…”

Section: Jz Indistinct or Invisible Ex Vivomentioning

confidence: 99%

See 1 more Smart Citation

Uterine junctional zone and adenomyosis: comparison of MRI, transvaginal ultrasound and histology

Harmsen

Trommelen

Leeuw

et al. 2023

Ultrasound in Obstet & Gyne

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Section: Jz Indistinct or Invisible Ex Vivomentioning

confidence: 99%

Section: Jz Indistinct or Invisible Ex Vivomentioning

confidence: 99%

Uterine junctional zone and adenomyosis: comparison of MRI, transvaginal ultrasound and histology

Harmsen

Trommelen

Leeuw

et al. 2023

Ultrasound in Obstet & Gyne

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“…Transient myometrial contraction is a common physiological phenomenon that can mimic pathological conditions such as focal or diffuse adenomyosis [ 18 ]. On MRI, it appears as a T2-hypointense region within the outer myometrium, potentially leading to bulging pseudo-thickening of the junctional zone, which can be confused with internal adenomyosis or DIE (Supplemental –Fig.…”

Section: Anatomical Variationsmentioning

confidence: 99%

Endometriosis MR mimickers: T2-hypointense lesions

Ruaux,

VanBuren,

Nougaret

et al. 2024

Insights Imaging

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Endometriosis is a common crippling disease in women of reproductive age. Magnetic resonance imaging (MRI) is considered the cornerstone radiological technique for both the diagnosis and management of endometriosis. While its sensitivity, especially in deep infiltrating endometriosis, is superior to that of ultrasonography, many sources of false-positive results exist, leading to a lack of specificity. Hypointense lesions or pseudo-lesions on T2-weighted images include anatomical variants, fibrous connective tissues, benign and malignant tumors, feces, surgical materials, and post treatment scars which may mimic deep pelvic infiltrating endometriosis. False positives can have a major impact on patient management, from diagnosis to medical or surgical treatment. This educational review aims to help the radiologist acknowledge MRI criteria, pitfalls, and the differential diagnosis of deep pelvic infiltrating endometriosis to reduce false-positive results.Critical relevance statementMRI in deep infiltrating endometriosis has a 23% false-positive rate, leading to misdiagnosis. T2-hypointense lesions primarily result from anatomical variations, fibrous connective tissue, benign and malignant tumors, feces, surgical material, and post-treatment scars.Key points• MRI in DIE has a 23% false-positive rate, leading to potential misdiagnosis.• Anatomical variations, fibrous connective tissues, neoplasms, and surgical alterations are the main sources of T2-hypointense mimickers.• Multisequence interpretation, morphologic assessment, and precise anatomic localization are crucial to prevent overdiagnosis.• Gadolinium injection is beneficial for assessing endometriosis differential diagnosis only in specific conditions. Graphical Abstract

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“…Uterine contractions can be measured using invasive techniques such as intrauterine pressure measurement [ 7 , 8 ] and electromyography [ 9 ] or non-invasive molecular imaging techniques such as three-dimensional (3D) ultrasounds [ 9 ] or magnetic resonance imaging [ 10 ]. In vivo, pressure recordings and ultrasound can themselves contribute to contractility, and magnetic resonance imaging (MRI) and ultrasounds do not give spatial and quantitative waveform metrics such as amplitude, frequency, and velocity [ 11–13 ].…”

Section: Introductionmentioning

confidence: 99%

Imaging the dynamics of murine uterine contractions in early pregnancy

Dawson,

Flores,

Zou

et al. 2024

Biology of Reproduction

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Uterine muscle contractility is essential for reproductive processes including sperm and embryo transport, and during the uterine cycle to remove menstrual effluent. Even still, uterine contractions have primarily been studied in the context of preterm labor. This is partly due to a lack of methods for studying the uterine muscle contractility in the intact organ. Here, we describe an imaging-based method to evaluate mouse uterine contractility of both the longitudinal and circular muscles in the cycling stages and in early pregnancy. By transforming the image-based data into 3D spatiotemporal contractility maps, we calculate waveform characteristics of muscle contractions, including amplitude, frequency, wavelength, and velocity. We report that the native organ is highly contractile during the progesterone-dominant diestrus stage of the cycle when compared to the estrogen-dominant proestrus and estrus stages. We also observed that during the first phase of uterine embryo movement when clustered embryos move towards the middle of the uterine horn, contractions are dynamic and non-uniform between different segments of the uterine horn. In the second phase of embryo movement, contractions are more uniform and rhythmic throughout the uterine horn. Finally, in Lpar3-/- uteri, that display faster embryo movement, we observe global and regional increases in contractility. Our method provides a means to understand the wave characteristics of uterine smooth muscle in response to modulators and in genetic mutants. Better understanding uterine contractility in the early pregnancy stages is critical for the advancement of artificial reproductive technologies and a possibility of modulating embryo movement during clinical embryo transfers.

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Transient uterine contractions as a potential pathology mimic on premenopausal pelvic MRI and the role of routine repeat T2 sagittal images to improve observer confidence

Cited by 6 publications

References 14 publications

Uterine junctional zone and adenomyosis: comparison of MRI, transvaginal ultrasound and histology

Uterine junctional zone and adenomyosis: comparison of MRI, transvaginal ultrasound and histology

Endometriosis MR mimickers: T2-hypointense lesions

Imaging the dynamics of murine uterine contractions in early pregnancy

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