Radiation-induced uterine changes: MR imaging.

Abstract

To assess the capability of magnetic resonance (MR) imaging to demonstrate postirradiation changes in the uterus, MR studies of 23 patients who had undergone radiation therapy were retrospectively examined and compared with those of 30 patients who had not undergone radiation therapy. MR findings were correlated with posthysterectomy histologic findings. In premenopausal women, radiation therapy induced (a) a decrease in uterine size demonstrable as early as 3 months after therapy ended; (b) a decrease in signal intensity of the myometrium on T2-predominant MR images, reflecting a significant decrease in T2 relaxation time, demonstrable as early as 1 month after therapy; (c) a decrease in thickness and signal intensity of the endometrium demonstrable on T2-predominant images 6 months after therapy; and (d) loss of uterine zonal anatomy as early as 3 months after therapy. In postmenopausal women, irradiation did not significantly alter the MR imaging appearance of the uterus. These postirradiation MR changes in both the premenopausal and postmenopausal uteri appeared similar to the changes ordinarily seen on MR images of the nonirradiated postmenopausal uterus.

Pregnancies and live births after 20 transplantations of cryopreserved ovarian tissue in a single center

“…None of the four women concerned conceived, despite having regular cycles over an extended period. One explanation for the lack of conception might be damage to the myometrium, with impaired function in the musculature and atrophic endometrium and impaired vasculature (39,40). Although the data are limited, it may be suggested that women who wish to have children but who have been exposed to radiation are less likely to conceive.…”

Acute effects of pelvic irradiation on the adult uterus revealed by dynamic contrast-enhanced MRI

“…In this study of the acute uterine effects of pelvic RT by DCE MRI, post-RT changes in cervical length, junctional zone anatomy and endometrial thickness were identified. Although the pathophysiology underlying these radiographic findings is not certain, it may be hypothesised that cervical shortening and junctional zone changes reflect atrophy or early fibrosis [14]. The reduction in endometrial thickness must be interpreted with caution, because it changes significantly with normal hormonal variation, and MRI evaluations were not performed at a specific phase of the menstrual cycle; however, bearing this limitation in mind, the finding may also be a sign of atrophy.…”

“…To date, the only study on this topic was published in 1989 by Arrivé et al [14]. The authors compared the MRI studies of 23 patients who had undergone pelvic RT with 30 age-matched controls, and they correlated MR characteristics with posthysterectomy histological findings.…”

Impact de la radiothérapie sur la fertilité féminine

“…Ces effets pourraient cependant être liés à une carence estrogénique liée à une dysfonction ovarienne secondaire à l'irradiation. Arrive et al ont suivi les changements radiologiques de l'utérus de femmes traitées par radiothérapie pelvienne à la dose de 40-65 Gy [31]. À l'IRM, ils ont observé l'apparition d'un hyposignal en séquences T2 dans le myomètre, suivi d'une diminution de taille de l'utérus à 3 mois, puis de l'épaisseur du myomètre 5 mois après la radiothérapie.…”