Role of Diffusion-Weighted Magnetic Resonance Imaging in the Diagnosis of Bladder Pain Syndrome/Interstitial Cystitis

Porru, Daniele; Cesare, Regina; Bright, Oworae Howardson; Fiorello, Nicolò; Gardella, Barbara; Manzoni, Federica; Klersy, Catherine; Gabriella, Sala Maria; Alfredo, La Fianza; Ballerini, Daniela; Preda, Lorenzo; Simeone, Claudio; Spinillo, Arsenio; Jallous, H

doi:10.1016/j.urology.2020.03.019

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…Since the discovery of Huuner's lesion more than 100 years ago, patients with IC/BPS had generally underwent cystoscopy, urodynamic study, and biopsy for histopathology, with radiological examinations for gross bladder morphology being rare. Several recent pilot studies, however, have utilized MRI to evaluate bladder wall changes in patients with IC/BPS [11][12][13]. Although evidence had suggested that MRI could be used for noninvasive diagnosis of IC/BPS, the association between clinical characteristics and abnormal findings have yet to be analyzed.…”

Section: Discussionmentioning

confidence: 99%

Possible Association between Bladder Wall Morphological Changes on Computed Tomography and Bladder-Centered Interstitial Cystitis/Bladder Pain Syndrome

Jhang

Hsu

et al. 2021

Biomedicines

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This study aimed to evaluate the clinical significance of urinary bladder wall thickening on computed tomography (CT) among patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Patients with IC/BPS were prospectively enrolled and classified into three groups according to bladder CT finding: smooth bladder wall, focal bladder thickening, and diffuse bladder thickening. Among the 100 patients with IC/BPS, 49, 36, and 15 had smooth bladder wall, focal bladder thickening, and diffuse bladder thickening on CT, respectively. Patients with Hunner’s lesion showed a higher proportion of diffuse and focal bladder thickening compared to those without the same (p < 0.001). Patients with diffuse bladder thickening displayed smaller first sensation of filling, cystometric bladder capacity, and voided volume compared to the rest (all p < 0.001). Patients with focal and diffuse thickening had a higher proportion of inflammatory cell infiltration, uroepithelial cell denudation, and granulation tissue compared to those with smooth bladder wall (p = 0.045, 0.002, and 0.005, respectively). Bladder wall thickening on CT was correlated with clinical phenotypes of IC/BPS, including histopathological findings. Focal or diffuse bladder wall thickening on CT might indicate the presence of chronic bladder wall inflammation and fibrosis and could be used to differentiate bladder-centered IC/BPS.

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Section: Discussionmentioning

confidence: 99%

Possible Association between Bladder Wall Morphological Changes on Computed Tomography and Bladder-Centered Interstitial Cystitis/Bladder Pain Syndrome

Jhang

Hsu

et al. 2021

Biomedicines

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Section: Mri Imagingmentioning

confidence: 99%

“…Recently, diffusion-weighted MRI (DW-MRI) or DWI has been used for the diagnosis of IC/BPS, where a high DW-MRI signal was found to be substantially higher in IC patients compared to normal controls [ 50 , 51 ]. They suggested that having a positive DW-MRI signal was suggestive of IC [ 50 ]. Unfortunately, in either study, they did not specifically measure the apparent diffusion coefficient (ADC), which should increase with increased inflammation, however, which may also contribute to calculation errors if low b-values are used which also takes into consideration the effect of perfusion [ 52 ].…”

Section: Mri Imagingmentioning

confidence: 99%

MRI as a Tool to Assess Interstitial Cystitis Associated Bladder and Brain Pathologies

et al. 2021

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic, often incapacitating condition characterized by pain seeming to originate in the bladder in conjunction with lower urinary tract symptoms of frequency and urgency, and consists of a wide range of clinical phenotypes with diverse etiologies. There are currently no diagnostic tests for IC/BPS. Magnetic resonance imaging (MRI) is a relatively new tool to assess IC/BPS. There are several methodologies that can be applied to assess either bladder wall or brain-associated alterations in tissue morphology and/or pain. IC/BPS is commonly associated with bladder wall hyperpermeability (BWH), particularly in severe cases. Our group developed a contrast-enhanced magnetic resonance imaging (CE-MRI) approach to assess BWH in preclinical models for IC/BPS, as well as for a pilot study for IC/BPS patients. We have also used the CE-MRI approach to assess possible therapies to alleviate the BWH in preclinical models for IC/BPS, which will hopefully pave the way for future clinical trials. In addition, we have used molecular-targeted MRI (mt-MRI) to quantitatively assess BWH biomarkers. Biomarkers, such as claudin-2, may be important to assess and determine the severity of BWH, as well as to assess therapeutic efficacy. Others have also used other MRI approaches to assess the bladder wall structural alterations with diffusion-weighted imaging (DWI), by measuring changes in the apparent diffusion coefficient (ADC), diffusion tensor imaging (DTI), as well as using functional MRI (fMRI) to assess pain and morphological MRI or DWI to assess anatomical or structural changes in the brains of patients with IC/BPS. It would be beneficial if MRI-based diagnostic tests could be routinely used for these patients and possibly used to assess potential therapeutics.

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“…Since Yang performed MRI scans on patients with pelvic floor dysfunction for the first time in 1991, with the development and updating of MRI machines and imaging techniques, pelvic floor MRI has gradually developed from static MRI, dynamic MRI, and functional MRI [ 7 ]. Combining a variety of MRI imaging techniques can not only help diagnose and analyze the changes of the three-chamber pelvic floor in real time, but also discover the changes and damage of anatomical structures under different pathological conditions and explore the pathogenesis [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value and Clinical Application of Diffusion‐Weighted Magnetic Resonance Imaging for Female Pelvic Lesions

Gao

2022

Contrast Media & Molecular Imaging

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Pelvic inflammatory disease refers to a group of infectious diseases of the female upper genital tract, often caused by ascending infection of vaginitis and cervicitis, causing endometritis, salpingitis, tubo-ovarian abscess, pelvic connective tissue inflammation, and/or pelvic peritonitis. PID is the most common and important infectious disease in nonpregnant women of childbearing age, and inflammation in multiple parts often coexists and affects each other. The functional MRI techniques currently used in pelvic floor muscle injury are magnetic resonance diffusion tensor imaging, T2 mapping, and magnetic resonance elastography. Diffusion tensor imaging is a new imaging and postprocessing technology developed on the basis of magnetic resonance diffusion-weighted imaging. Due to the lack of specificity of clinical symptoms, many subclinical patients are often not detected and diagnosed in time, so it is very difficult to accurately estimate the incidence of PID. This article retrospectively analyzed 72 patients with pelvic inflammatory disease confirmed by surgical pathology from February 2020 to 2022, who had undergone pelvic MRI examination before surgery, including 25 patients with chronic pelvic inflammation (hydrosalpinx), 25 patients with acute pelvic inflammation, and 47 cases (including 21 cases of hydrosalpinx, 19 cases of tubo-ovarian abscess, and 7 cases of pelvic abscess). The age range was 13 to 59 years old. The clinical data and MRI findings were analyzed, the ADC value of the cystic part of the lesion was measured, and the differences in age, maximum diameter of the lesion, thickness of the vessel wall/separation, and the ADC value of the cystic part of chronic and acute pelvic inflammation were compared. In this part of the cases, there were 25 cases of chronic pelvic inflammation and 47 cases of acute pelvic inflammation. The average ADC value of the cystic component of chronic inflammation was significantly higher than that of acute inflammation, which were (2.86 ± 0.20) × 10−3 mm2/s and (1.07 ± 0.38) ×10−3 mm2/s, respectively, P value <0.001.

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Role of Diffusion-Weighted Magnetic Resonance Imaging in the Diagnosis of Bladder Pain Syndrome/Interstitial Cystitis

Cited by 5 publications

References 9 publications

Possible Association between Bladder Wall Morphological Changes on Computed Tomography and Bladder-Centered Interstitial Cystitis/Bladder Pain Syndrome

Possible Association between Bladder Wall Morphological Changes on Computed Tomography and Bladder-Centered Interstitial Cystitis/Bladder Pain Syndrome

MRI as a Tool to Assess Interstitial Cystitis Associated Bladder and Brain Pathologies

Diagnostic Value and Clinical Application of Diffusion‐Weighted Magnetic Resonance Imaging for Female Pelvic Lesions

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