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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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 QUESTION: What 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? DESIGN: A 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. RESULTS: Seventy-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. CONCLUSIONS: A 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 Adenomyosis Adult Adult Contraceptive Agents, Female Contraceptive Agents, Female Disease Progression Disease Progression Female Female Humans Humans Leiomyoma Leiomyoma Magnetic Resonance Imaging

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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