Value of diffusion-weighted magnetic resonance imaging in the diagnosis of pyomyoma

Peris, Helena; Riego, Javier del; Criado, Eva; García-Chamón, Rosa Belén; Vall, Elisenda; Mayoral, María; Martín, Amaya

doi:10.1016/j.radcr.2021.10.018

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…Degenerated fibroids, as in the present case, are characterized by a high signal on T1-weighted images with high marginal signals and poor contrast effect [ 13 ]. A recent case report shows that a marked restriction on DWI sequence has provided a suspicion of abscess formation [ 14 ]. In the present case, CT revealed a degenerative change in the fibroid.…”

Section: Discussionmentioning

confidence: 99%

Postpartum pyomyoma due to Mycoplasma hominis: A case report

Mitoma

Oba²,

Mishima³

et al. 2022

Case Reports in Women's Health

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Section: Discussionmentioning

confidence: 99%

Postpartum pyomyoma due to Mycoplasma hominis: A case report

Mitoma

Oba²,

Mishima³

et al. 2022

Case Reports in Women's Health

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“…Several imaging modalities can aid the diagnosis of pyomyoma, including ultrasonography, Computer Tomography (CT) scan and MRI [4,[18][19][20][21]. Transvaginal ultrasound may reveal an enlarged uterus with a heterogenous, echogenic mass and acoustic shadowing due to gas.…”

Section: Discussionmentioning

confidence: 99%

“…On MR examination, the cystic components of pyomyoma appear hypointense on T1 and a fibrous capsule may be appreciated [19]. Furthermore, Diffusion Weighted Imaging (DWI) excels at localizing abscesses and may play a role in guiding biopsy to confirm the diagnosis before surgery [20].…”

Section: Discussionmentioning

confidence: 99%

Large pyomyoma after an urgent uterine artery embolization (UAE)

Bechay¹,

Thomas²,

Le³

et al. 2022

J Clin Images Med Case Rep

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Leiomyomas, or fibroids, are a common, benign tumor of the smooth muscle of the uterus, with a cumulative incidence of 70% in white women and 80% in black women by age 50 [1]. Suppurative leiomyoma, also referred to as pyomyoma, is a rare disorder of infarction with subsequent infection of a leiomyoma, which must be distinguished from other degenerative changes [2,3]. Incidence of the disease is unknown but previously estimated under 1% of operated fibroids [3], and there have been approximately 100 cases reported since 1945. The modes of infection are thought to be via direct extension from the uterine cavity, a lymphatic or a vascular route of bacterial seeding [3,4]. Pregnancy, the post-partum period, and uterine instrumentation, including dilatation and curettage (D&C) and C-section, are important risk factors for direct inoculation and account for the majority of pyomyoma cases that were reported [5,6]. Idiopathic pyomyomas also occur, such as in post-menopausal women; risk factors for ischemia, such as hypertension, diabetes, and atherosclerosis, increase the risk of pyomyoma [4,5]. Uterine Artery Embolization (UAE) is increasingly used as a non-invasive treatment for symptomatic fibroids and involves infarction of leiomyomas, which can rarely lead to pyomyoma [7,8]. We present a case of pyomyoma that developed after an urgent uterine artery embolization with a follow-up discussion of the relevant literature.

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“…In comparison of pelvic anatomy, the mid-sagittal, sagittal, coronal, and axial dynamic MRI images were collected every time the patient's resting phase-levator phase-relaxation phase-force-reflex phase was taken as a cycle [ 15 ]. The female pelvic floor has multiple layers of complex anatomical structures, and the muscles of the pelvic floor are like a “slinging net,” which tightly hangs the pelvic floor organs and maintains their normal position and function [ 16 ]. When the elasticity of the pelvic floor muscles becomes poor, the internal organs of the pelvic floor cannot maintain their normal positions, and the corresponding functions are impaired [ 17 ].…”

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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Value of diffusion-weighted magnetic resonance imaging in the diagnosis of pyomyoma

Cited by 6 publications

References 12 publications

Postpartum pyomyoma due to Mycoplasma hominis: A case report

Postpartum pyomyoma due to Mycoplasma hominis: A case report

Large pyomyoma after an urgent uterine artery embolization (UAE)

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

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