Progression of adenomyosis magnetic resonance imaging features under ulipristal acetate for symptomatic fibroids

Lisa Calderon, Calderon L, Antoine Netter, A Netter, Anaïs Grob-Vaillant, Grob-Vaillant A, Julien Mancini, Siles P, Pascale Siles, Vincent Vidal, Vidal V, Agostini A, Aubert Agostini
Reproductive BioMedicine Online · 2020 · vol. 42(3) , pp. 661–668 · doi:10.1016/j.rbmo.2020.11.012 · PMID:33349531 · W3106963393
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This study investigated how magnetic resonance imaging features of adenomyosis change during ulipristal acetate treatment for symptomatic uterine fibroids.

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Abstract

Research questionWhat is the evolution of adenomyosis on magnetic resonance imaging (MRI) after a 3-month treatment course of daily 5 mg doses of ulipristal acetate (UPA) for symptomatic fibroids?DesignA monocentric prospective pilot study on patients who underwent a 3-month treatment course of UPA for symptomatic fibroids between January 2014 and December 2017. Patients underwent pelvic MRI shortly before (pre-MRI) and after treatment (post-MRI). The diagnosis of adenomyosis on MRI was defined by the observation of intramyometrial cysts and/or haemorrhagic foci within these cystic cavities and/or a thickening of the junctional zone >12 mm. The progression of adenomyosis was defined by the presence of at least one of the aforementioned criteria of adenomyosis on the pre-MRI and by at least one of the following on the post-MRI: (i) increased thickness of the junctional zone ≥20% and/or (ii) increased number of intramyometrial cysts. The appearance of adenomyosis was defined by the absence of the aforementioned criteria of adenomyosis on the pre-MRI and the presence of at least one of these criteria on the post-MRI.ResultsSeventy-two patients were included. The MRI features of adenomyosis progressed for 12 of 15 patients (80.0%) for whom adenomyosis was identified on the pre-MRI. An appearance of adenomyosis was identified after treatment for 15 of 57 patients (26.3%) for whom adenomyosis was not identified on the pre-MRI.ConclusionsA 3-month treatment course of daily 5 mg doses of UPA could provoke a short-term progression or an emergence of typical adenomyosis intramyometrial cysts on MRI examinations.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Contraceptive Agents, Female Leiomyoma Norpregnadienes Adenomyosis Adenomyosis Adult Contraceptive Agents, Female Disease Progression Female Humans Leiomyoma Magnetic Resonance Imaging Norpregnadienes Pilot Projects Prospective Studies

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