The Role of Magnetic Resonance Imaging–Diffusion Tensor Imaging in Predicting Pain Related to Endometriosis: A Preliminary Study

Porpora, Maria Grazia; Vinci, Valeria; Vito, Corrado De; Migliara, Giuseppe; Anastasi, Emanuela; Ticino, Adele; Resta, Serena; Catalano, Carlo; Panici, Pierluigi Benedetti; Manganaro, Lucia

doi:10.1016/j.jmig.2017.10.033

Cited by 24 publications

(26 citation statements)

References 35 publications

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“…When the endometrial zona basalis is damaged, the endometrium directly invades the adjacent JZ, resulting in diffuse or limited thickening of JZ and adenomyosis formation. Imaging changes of JZ lesions detected by ultrasound and magnetic resonance imaging (MRI) have become reliable indicators for clinically diagnosing adenomyosis[1,2]. Cystic adenomyosis, also known as cystic adenomyoma or adenomyotic cyst, is a special type of adenomyosis, which is a cystic structure lining the endometrium and covered with the uterine smooth muscle, containing old blood cyst fluid.…”

Section: Introductionmentioning

confidence: 99%

Intrauterine cystic adenomyosis: Report of two cases

Liu

2019

WJCC

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BACKGROUND Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Because cystic uterine adenomyosis is rare in clinical work, it can be easily misdiagnosed or its diagnosis can be missed. Early surgical treatment and postoperative drug treatment can alleviate dysmenorrhea, menorrhagia, anemia, and other symptoms. CASE SUMMARY Two cases complained about abnormal vaginal bleeding and were diagnosed with intrauterine cystic adenomyosis by gynecological ultrasound and pathological examination. The clinical manifestations included dysmenorrhea, hypermenorrhea, and a history of cesarean section. Both cases underwent a surgery, and chocolate-like liquid was released from the cystic mass in the uterus and the manifestations were relieved. CONCLUSION Intrauterine cystic adenomyosis could be diagnosed by pathological examination and treated by hysterectomy or hystscopy to release the liquid inside.

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Section: Introductionmentioning

confidence: 99%

Intrauterine cystic adenomyosis: Report of two cases

Liu

2019

WJCC

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“…10 Nociceptor input produces pain hypersensitivity, resulting in secondary alterations in brain activity, which can be detected by imaging techniques. Porpora et al 11 observed a decrease in gray matter volume in certain areas of the cerebral cortex via cranial MRI in patients with long-term chronic pain, suggesting that changes in the pain center of the brain may be related to chronic pain.…”

Section: Introductionmentioning

confidence: 99%

<p>Central Sensitization-Related Changes in Brain Function Activity in a Rat Endometriosis-Associated Pain Model</p>

Zheng¹,

Jia²,

Guo³

et al. 2020

JPR

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Background: Pain sensitization processing in the central nervous system may be related to endometriosis-associated pain in patients. The purpose of this study was to understand the alterations in the abnormal pain response in central brain areas and explore the central sensitization mechanism of endometriosis-associated pain. Methods: An endometriosis model was established in 40 Sprague-Dawley rats, and the rats underwent pain model assessment through behavioral tests. Twenty Sprague-Dawley rats underwent a sham operation as the control group. Thirteen pain rats and 8 control rats received Rs-fMRI examination to explore the brain functional activity areas, and the regional homogeneity (ReHo) method was used to analyze relevant functional signals among the whole brain. The states of neurons and expression of TRPV1 and NMDRA located in the abnormal ReHo signal brain regions were observed using Nissl staining, qRT-PCR and immunohistochemistry. Results: The rats were divided into a pain group and a control group based on the different syndromes and behavioral assessments. We detected significant enhancement of ReHo signals in the anterior cingulate cortex, hippocampus, and thalamus and a reduction in the ReHo values in the basomedial amygdaloid nucleus (BM) and primary motor cortex (M1) in the pain rat group via Rs-fMRI examination. The number of Nissl bodies and apoptotic neurons was increased; moreover, the volume of neurons increased compensatorily in the cingulate cortex, thalamus and hippocampus in the pain group. TRPV1 and NMDRA were overexpressed in apoptotic neurons in the higher ReHo value brain regions in the endometriosis pain group. Conclusion: These findings suggest that in rats with endometriosis-associated pain, ReHo signal enhancement was observed in the cingulate cortex, thalamus and hippocampus, which may be due to the increase in the number of apoptotic neurons or the compensatory increase in the volume of overactive neurons.

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“…[54][55][56] More recently, the use of diffusion tensor imaging has also been explored in uterine and gynecological disorders like endometriosis, malignancies, and uterine fibroids, suggesting great potential in the use of these techniques in gynecological conditions. 57,58 Their diagnostic potential remains to be definitively evaluated; however, the one study that investigated diffusion tensor imaging for its diagnostic potential showed superior accuracy over conventional MRI. 16 There are several limitations which may impact our results.…”

Section: Correlation With Clinical Outcomesmentioning

confidence: 99%

Objective measures of adenomyosis on MRI and their diagnostic accuracy—a systematic review & meta‐analysis

Rees

Mischi

Vliet

et al. 2021

Acta Obstet Gynecol Scand

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Introduction: Magnetic resonance imaging (MRI) diagnosis of adenomyosis is considered the most accurate non-invasive technique, but remains subjective, with no consensus on which diagnostic parameters are most accurate. We aimed to systematically review the literature on how adenomyosis can be objectively quantified on MRI in a scoping manner, to review the diagnostic performance of these characteristics compared with histopathological diagnosis, and to summarize correlations between measures of adenomyosis on MRI and clinical outcomes. Material and methods:We searched databases Pubmed, Embase, and Cochrane for relevant literature up to April 2020 according to PRISMA guidelines. We included studies that objectively assessed adenomyosis on MRI, and separately assessed studies investigating the diagnostic performance of MRI vs histopathology for inclusion in a meta-analysis. The QUADAS-2 tool was used for risk of bias, with many studies showing an unclear or high risk of bias.Results: Eighty studies were included, of which 14 assessed the diagnostic performance of individual MRI parameters, with four included in the meta-analysis of diagnostic accuracy. Common MRI parameters were: junctional zone (JZ) characteristics, such as maximum JZ thickness-pooled sensitivity 71.6% (95% CI 46.0%-88.2%), specificity 85.5% (52.3%-97.0%); JZ differential-pooled sensitivity 58.9% (95% CI 44.3%-72.1%), specificity 83.2% (95% CI 71.3%-90.8%); and JZ to myometrial ratiopooled sensitivity 63.3% (95% CI 51.9%-73.4%), specificity 79.4% (95% CI 42.0%-95.4%); adenomyosis lesion size, uterine morphology (pooled sensitivity 42.9% (95% CI 15.9%-74.9%), specificity 87.7%, (95% CI 37.9-98.8) and changes in signal intensity-eg, presence of myometrium cysts; pooled 59.6% (95% CI 41.6%-75.4%) and specificity of 96.1% (95% CI 80.7%-99.3%). Other MRI parameters have been used for adenomyosis diagnosis, but their diagnostic performance is unknown. Few studies attempted to correlate adenomyosis MRI phenotype to clinical outcomes. Conclusions:A wide range of objective parameters for adenomyosis exist on MRI; however, in many cases their individual diagnostic performance remains uncertain.We included studies investigating the diagnosis, evaluation or classification of adenomyosis objectively based on MRI. Studies were included regardless of study design, use of hormonal therapy, age, or clinical manifestation. Studies written in English, Dutch or French were considered for inclusion, published up to April 7, 2020.Data reported in secondary analysis (reviews), case reports, letters to editors, conference abstracts, and protocols for ongoing JZ characteristics remain the most widely used and investigated with acceptable diagnostic accuracy. Specific research is needed into how these objective measures of adenomyosis can be correlated to clinical outcomes.

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The Role of Magnetic Resonance Imaging–Diffusion Tensor Imaging in Predicting Pain Related to Endometriosis: A Preliminary Study

Cited by 24 publications

References 35 publications

Intrauterine cystic adenomyosis: Report of two cases

Intrauterine cystic adenomyosis: Report of two cases

<p>Central Sensitization-Related Changes in Brain Function Activity in a Rat Endometriosis-Associated Pain Model</p>

Objective measures of adenomyosis on MRI and their diagnostic accuracy—a systematic review & meta‐analysis

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