Perfusion of the uterine junctional zone in nulliparous and primiparous women assessed by DCE-MRI, as a function of menstrual cycle and hormonal contraception

Meylaerts, L; Wijnen, Leen; Bazot, Marc; Grieten, Martijn; Ombelet, Willem; Vandersteen, Marjan

doi:10.1016/j.mri.2016.12.026

Cited by 3 publications

(9 citation statements)

References 24 publications

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“…A sharp increase in vascularity was seen in the JZ during the follicular phase with a pre-ovulatory peak and a post-ovulatory fall, then another increase at the end of the luteal phase 77 . These findings are in accordance with the DCE-MRI findings 40,41 .…”

Section: Normal Transvaginal Ultrasound Appearancesupporting

confidence: 92%

“…The suggestion that blood volume, as an extracellular water containing space, could cause the difference in signal intensity between the different uterine layers was not convincingly refuted nor confirmed 23,28 . Signs of reduced water content and increased cell density were also observed by a reduced apparent diffusion coefficient (ADC) in Diffusion Weighted Imaging (DWI) in the junctional zone compared to the outer myometrium 40,41 . The role of blood flow was re-evaluated in more recent and larger studies by dynamic contrast enhanced (DCE) MRI (Table 2) 40,41 Overall, these findings suggest a higher vascular perfusion rate, a higher velocity of tissue blood flow in the capillaries and a greater capillary permeability in the junctional zone than in the outer myometrium (Figure 3B1 and 3B2).…”

Section: Normal Mri Appearancementioning

confidence: 99%

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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: Normal Transvaginal Ultrasound Appearancesupporting

confidence: 92%

Section: Normal Mri Appearancementioning

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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“…It is the dominant pattern in every phase of the menstrual cycle. In accordance with previous data collected from MRI perfusion studies, we observed a trend of more intense enhancement of the myometrium in the follicular and ovulatory phases compared to the luteal phase (9–11). However, the difference was not statistically significant, perhaps due to the relatively small sample size.…”

Section: Discussionsupporting

confidence: 92%

“…Magnetic resonance imaging (MRI) is an alternative diagnostic method with excellent intrinsic tissue contrast resolution. The uterine anatomy (4–8) and the perfusion of the myometrium observed on dynamic contrast-enhanced MRI (9,10) have been described in detail in MRI studies.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography contrast enhancement pattern of the uterus in premenopausal women in relation to menstrual cycle and hormonal contraception

et al. 2020

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Background There are different types of computed tomography (CT) contrast enhancement patterns of the uterus. It is not known whether these are hormonally dependent. Purpose To assess the relationship between these patterns and the menstrual cycle in non-users of hormonal contraception, and the possible impact of hormonal contraception. Material and Methods Prospective observational study of abdominal CT scans of 53 premenopausal women of whom 28 were non-users and 25 users of hormonal contraception. The non-users were divided according to menstrual cycle phase: follicular (n = 12); ovulatory (n = 1); and luteal (n = 12). The pattern and intensity of contrast enhancement of the uterine myometrium were assessed. Results The dominant pattern of contrast enhancement of the myometrium was the diffuse homogeneous type in both non-users and users. The intensity of the enhancement measured in Hounsfield units (HU) was higher in the follicular phase (median 102, range 73–130) compared to the luteal phase in non-users (median 92, range 57–130); however this was not statistically significant ( P = 0.2). The HU values observed in users (median 95, range 45–160) were at the same levels compared to those of the luteal phase in non-users. Conclusion The dominant pattern of contrast enhancement in the portal venous phase of the myometrium in fertile ages is the diffuse homogeneous type and is independent of menstrual cycle phase or the use of hormonal contraception. However, these factors seem to play a role in the intensity of contrast enhancement, with a tendency of higher HU values in the follicular phase of non-users.

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“…It seems also that the expression of oxytocin receptors is somewhat dependent on the menstrual cycle with some reports suggesting that the blood flow is higher during the follicular and ovulatory phase compared to the luteal phase [23]. Despite our initial efforts, we could not assess this phenomenon in our study, since we were not able to synchronize the MR-imaging with the menstrual cycle of the women.…”

Section: Discussionmentioning

confidence: 92%

Oxytocin selectively reduces blood flow in uterine fibroids without an effect on myometrial blood flow: a dynamic contrast enhanced MRI evaluation

Otonkoski

Sainio

Komar

et al. 2020

International Journal of Hyperthermia

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Introduction: Uterine fibroids are the most common benign neoplasms in women. The administration of intravenous oxytocin is known to increase the efficacy of a non-invasive thermal ablation method (MR-HIFU) for treating fibroids. However, it is not known whether this phenomenon is caused by the effect of the oxytocin on the myometrium or the fibroid itself. The objective of this study was to evaluate the influence of oxytocin on the blood flow of fibroids, myometrium and skeletal muscle using a quantitative perfusion MRI technique. Materials and methods: 17 premenopausal women with fibroids considered to be treated with MR-HIFU and 11 women with no fibroids were enrolled in the study. An extended MRI protocol of the pelvis was acquired for each subject. Later another MRI scan was performed with continuous intravenous infusion of oxytocin. The effect of oxytocin was analyzed from quantitative perfusion imaging. The study was registered in clinicaltrials.gov NCT03937401. Results: Oxytocin decreased the blood flow of each fibroid; the median blood flow of fibroid was 39.9 ml/100 g tissue/min without and 3.5 mL/100 g/min with oxytocin (p 0.0001). Oxytocin did not affect the blood flow of the myometrium in either group. Oxytocin increased the blood flow of the skeletal muscle in both groups (p ¼ 0.04). Conclusion: Oxytocin is effective in decreasing the blood flow in fibroids while having minor or no effect on the blood flow of normal myometrium. Routine use of oxytocin in HIFU therapy may make the therapy suitable to a larger group of women in a safe manner.

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Perfusion of the uterine junctional zone in nulliparous and primiparous women assessed by DCE-MRI, as a function of menstrual cycle and hormonal contraception

Abstract: This study provides data on normal perfusion parameters of inner and outer myometrium, which may be potentially useful in assisted reproductive therapy.

Cited by 3 publications

References 24 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

Computed tomography contrast enhancement pattern of the uterus in premenopausal women in relation to menstrual cycle and hormonal contraception

Oxytocin selectively reduces blood flow in uterine fibroids without an effect on myometrial blood flow: a dynamic contrast enhanced MRI evaluation

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