Value of Magnetic Resonance Imaging in Diagnosis of Adenomyosis and Myomas of the Uterus

Stamatopoulos, Charalampos; Mikos, Themistoklis; Grimbizis, Grigoris; Dimitriadis, Athanasios; Efstratiou, Ioannis; Stamatopoulos, P; Tarlatzis, Basil C.

doi:10.1016/j.jmig.2012.06.003

Cited by 58 publications

(32 citation statements)

References 34 publications

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“…The 8 cases of adenomyosis in our study showed variable MRI features, diffuse junctional zone thickening >12 mm, nodular/linear T 2 hyper intensities in the myometrium, subendometrial cystic lesions with or without hemorrhagic content, focal adenomyoma and even an adenomyotic prolapsed polyp in breast cancer patient receiving tamoxifen. Our study had higher detection rates (sensitivity of 87.5%, PPV of 100%,) than that of Stamatopoulos et al (15) who reported a sensitivity of 46.1%, and PPV of 92.3%. This could be because of a significantly larger sample size in their study, as well as inclusion of patients who were either symptomatic & asymptomatic with a pelvic mass.…”

Section: Discussioncontrasting

confidence: 67%

“…Due to its multiplanar capability, the peduncle of the leiomyomas can be demonstrated by MRI. Stamatopoulos CP et al (15) reported a sensitivity of 94.1% and PPV of 95.7% in detecting leiomyomas by MRI, whereas we had a 100% sensitivity & PPV. This is likely all our cases were large subserous fibroids presenting acutely (complicated by hemorrhage) which have a far more characteristic MRI appearance, than Stamatopoulos et al (15) who included both symptomatic & asymptomatic gynecological cases.…”

Section: Discussioncontrasting

confidence: 61%

“…In accordance with Singh et al (20) (sensitivity 86%, PPV 100%), we had similar results in diagnosing ovarian torsion by MRI with a sensitivity of 90% & specificity of 100%. Uterine leiomyomas are the commonest gynecological neoplasms in women of child bearing age (10,15). Women can present with acute symptoms when fibroids undergo degeneration (hemorrhage), prolapse or torsion (in pedunculated fibroids) (10).…”

Section: Discussionmentioning

confidence: 99%

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Revisiting the role of MRI in gynecological emergencies – An institutional experience

Fahmy

Swamy

Elshahat

2015

The Egyptian Journal of Radiology and Nuclear Medicine

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Objective: Gynecological emergencies continue to be a diagnostic challenge. Although ultrasound is an excellent first line imaging modality, there are many instances where sonographic findings are indeterminate. The purpose of this study was to assess the emerging role of MRI in gynecological emergencies. Methods: 88 patients with acute pelvic pain or bleeding per vagina who underwent MRI at our imaging department between October 2012 and September 2014 were reviewed. The final diagnosis was established by surgical findings in 69 cases, endovascular intervention & biopsy in 1 respectively. The remaining 17 cases underwent follow-up MRI. Results: MRI was diagnostic in 84 (95.5%) out of 88 patients and non-diagnostic in 4 cases. The commonest gynecological emergency was pelvic inflammatory disease. Imaging findings in 71 (80.7%) patients were correlated with surgery or biopsy. The overall sensitivity and PPV of MRI in acute gynecological pathologies was 96.6% and 98.8%. Conclusion: Women presenting to the emergency room with acute pelvic pathology require prompt diagnosis to ensure timely management. MRI is superior to ultrasound in pelvic lesion characterization and is the problem solving modality when initial ultrasound is inconclusive. Our study demonstrated that MRI can play a significant role in providing accurate diagnosis in gynecological emergencies.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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Revisiting the role of MRI in gynecological emergencies – An institutional experience

Fahmy

Swamy

Elshahat

2015

The Egyptian Journal of Radiology and Nuclear Medicine

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“…Magnetic resonance imaging is also an accurate, non-invasive modality for diagnosing adenomyosis with a high specificity (67%-99%) and accuracy (85%-95%) [89][90][91][95][96][97][98]. …”

Section: Magnetic Resonance Imaging Of Adenomyosis and Junctional Zonementioning

confidence: 99%

Imaging for the evaluation of endometriosis and adenomyosis

Exacoustòs

Manganaro

Zupi

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

212

143

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Endometriosis affects between 5 and 45% of women in reproductive age, is associated with significant morbidity, and constitutes a major public health concern. The correct diagnosis is fundamental in defining the best treatment strategy for endometriosis. Therefore, non-invasive methods are required to obtain accurate diagnoses of the location and extent of endometriotic lesions. Transvaginal sonography and magnetic resonance imaging are used most frequently to identify and characterise lesions in endometriosis. Subjective impression by an experienced sonologist for identifying endometriomas by ultrasound showed a high accuracy. Adhesions can be evaluated by real-time dynamic transvaginal sonography, using the sliding sign technique, to determine whether the uterus and ovaries glide freely over the posterior and anterior organs and tissues. Diagnosis is difficult when ovarian endometriomas are absent and endometriosis causes adhesions and deep infiltrating nodules in the pelvic organs. Magnetic resonance imaging seems to be useful in diagnosing all locations of endometriosis, and its diagnostic accuracy is similar to those obtained using ultrasound. Transvaginal ultrasound has been proposed as first line-line imaging technique because it is well accepted and widely available. The main limitation of ultrasound concerns lesions located above the rectosigmoid junction owing to the limited field-of-view of the transvaginal approach and low accuracy in detecting upper bowel lesions by transabdominal ultrasound. A detailed non-invasive diagnosis of the extension in the pelvis of endometriosis can facilitate the choice of a safe and adequate surgical or medical treatment

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“…Thickness was measured in the anterior and posterior walls at the thickest portion. A diagnosis of adenomyosis was made when the junctional zone was not uniform, in the presence of poorly delimited focal areas in the myometrium, and when the thickness of the junctional zone was ≥ 12 mm [10,11] (Fig. 2).…”

Section: Methodsmentioning

confidence: 99%

Impact of pelvic magnetic resonance imaging findings in the indication of uterine artery embolization in the treatment of myoma

et al. 2017

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Objectives: To assess the impact of pelvic magnetic resonance imaging (MRI) findings in the indication for uterine-artery embolization in women with fibroids, as well as the correlation between MRI and ultrasound (US) examinations for diagnosing adenomyosis. Material and methods:A retrospective observational study was performed through the analysis of the medical records of 263 women referred for uterine-artery embolization as treatment for fibroids after undergoing US and MRI examinations. To compare uterine volume and fibroid measurement in US and MRI, the Wilcoxon test was used; for the number of fibroids, the McNemar test was used. The kappa coefficient was used to evaluate the correlation between US and MRI findings for diagnosing adenomyosis. Results:The mean age of patients was 37.9 ± 6.8 years and 191 (72.6%) were nulliparous. Forty-three patients with adenomyosis associated with fibroid were diagnosed by MRI; US indicated the presence of adenomyosis in 12 (4.56%) women. There was agreement between MRI and US in the diagnosis of adenomyosis in 218/263 (82.9%) patients (p < 0.05). In the US examination, the mean uterine volume was lower (389 ± 340.8 cm³) than that observed in MRI (472.2 ± 415.9 cm³; p < 0.001). Regarding the number of fibroids, MRI showed a greater number of patients with multiple fibroids (68.8% vs. 57.4%, MRI and US, respectively; p < 0.001). Conclusions:In women with fibroids referred for uterine-artery embolization, MRI findings led to the revision of the initial diagnosis in 17.1% cases. US showed a lower sensitivity for diagnosing adenomyosis than MRI.

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Value of Magnetic Resonance Imaging in Diagnosis of Adenomyosis and Myomas of the Uterus

Cited by 58 publications

References 34 publications

Revisiting the role of MRI in gynecological emergencies – An institutional experience

Revisiting the role of MRI in gynecological emergencies – An institutional experience

Imaging for the evaluation of endometriosis and adenomyosis

Impact of pelvic magnetic resonance imaging findings in the indication of uterine artery embolization in the treatment of myoma

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