The role of cine magnetic resonance imaging in the evaluation of uterine contractility in patients with deep infiltrating endometriosis

<!-- Brazil - The role of cine magnetic resonance imaging in the evaluation of uterine contractility in patients with deep infiltrating endometriosis The role of cine magnetic resonance imaging in the evaluation of uterine contractility in patients with deep infiltrating endometriosis window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-MKLVK7B5B6'); .articleTxt{ top: -16px; } .scielo__border-top{ border-top: 1px solid #ccc !important; } @media (max-width: 575.98px) { .articleCtt > .container{ padding-left: 0; padding-right: 0; } .articleCtt .articleTxt{ padding-left: 16px !important; padding-right: 16px !important; } } @media (min-width: 768px){ .scielo__truncate{ display: block; max-width: 285px; } } menu Menu Brazil Journal list by title Journal list by subject area Search Metrics (abre em nova aba) Sobre o SciELO Brazil Contacts Report error SciELO.org - The SciELO Network (abre em nova aba) National and thematic collections (abre em nova aba) Journal list by title (abre em nova aba) Journal list by subject (abre em nova aba) Search (abre em nova aba) Metrics (abre em nova aba) OAI and RSS (abre em nova aba) About the SciELO Network (abre em nova aba) Contacts (abre em nova aba) Blog SciELO in Perspective (abre em nova aba) document.addEventListener('DOMContentLoaded', function () { const wrapper = document.getElementById('scieloMainMenu'); 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The investigation of the most common causes of female infertility includes the characterization of congenital anomalies of uterine morphology, by transvaginal ultrasound and magnetic resonance imaging (MRI); the evaluation of tubal patency by hysterosalpingography and magnetic resonance hysterosalpingography; and the evaluation of ovarian reserve and other clinical conditions, such as endometriosis, adenomyosis, and uterine fibroids. In recent years, there have been a number of studies employing cine MRI for the evaluation of uterine contractility, demonstrating altered uterine peristalsis in patients with endometriosis, adenomyosis, or uterine fibroids( 1 , 2 ). The article “Deep infiltrating endometriosis: cine magnetic resonance imaging in the evaluation of uterine contractility”, authored by Soares et al.( 3 ) and published in this issue of Radiologia Brasileira, describes the use of cine MRI in a 3.0-T scanner, for the evaluation of uterine peristalsis by characterizing the contractile movements of the uterus in patients with uterine endometriosis and adenomyosis. The authors evaluated 43 patients, of whom 18 had a radiological diagnosis of endometriosis. They found that, in the periovulatory and luteal phases, uterine peristalsis was more common among patients with deep endometriosis than among those in the control group. Among the patients diagnosed with adenomyosis, uterine contractility was significantly lower that that observed for the patients in the control group. Soares et al.( 3 ) carried out a prospective study and expanded the exclusion criteria, which is one of the strengths of their article, with attention to factors that are known to affect uterine peristalsis, such as the use of hormonal contraceptives, the use of intrauterine devices, having amenorrhea ( 4 ), and being in the menstrual phase. Excluding patients who presented with any of those factors increased the robustness of the findings. It is questionable whether the use of those exclusion criteria was responsible for the fact that Soares et al.( 3 ) obtained results that diverge from those of previous studies on the topic, in which uterine peristalsis was reported to be less common in patients with endometriosis( 5 ). The authors’ choice not to use antispasmodics (which could affect uterine contractility) prior to the MRI examination is evidence of the care taken in order to obtain reliable results, as well as demonstrating the need to adapt the timing of the administration of that medication, which is routinely used during female pelvic examinations at most imaging centers, in order to minimize artifacts related to intestinal peristalsis. The main limitations of the Soares et al.( 3 ) study, as noted by the authors themselves, are the relatively small size of the sample evaluated and the fact that the statistical analysis did not reveal a significant result regarding changes in peristalsis in patients with endometriosis. Their research could be expanded upon in studies involving larger patient samples and correlation with the different phases of the menstrual cycle, as well as evaluation of the impact of contractility. Soares et al.( 3 ) demonstrated that the functional evaluation of uterine contractility by MRI is emerging as a promising field of research, which will undoubtedly enhance the investigation of female infertility( 6 , 7 ). It is also possible that this approach will improve the quality of cine MRI sequences acquired in 1.5-T scanners, thus making such evaluations accessible to more patients. REFERENCES 1 Kido A, Togashi K. Uterine anatomy and function on cine magnetic resonance imaging. Reprod Med Biol. 2016;15:191-9. 2 Soares DM, Werner Junior H, Bittencourt LK, et al. The role of cine MR in the assessment of uterine function. Arch Gynecol Obstet. 2019;300:545-53. 3 Soares DM, Bittencourt LK, Lopes FPPL, et al. Deep infiltrating endometriosis: cine magnetic resonance imaging in the evaluation of uterine contractility. Radiol Bras. 2023;56:119-25. 4 Fornazari VAV, Salazar GMM, Vayego SA, et al. Impact of uterine contractility on quality of life of women undergoing uterine fibroid embolization. CVIR Endovasc. 2019;2:36. 5 Kido A, Togashi K, Nishino M, et al. Cine MR imaging of uterine peristalsis in patients with endometriosis. Eur Radiol. 2007;17:1813-9. 6 Bazot M, Daraï E. Diagnosis of deep endometriosis: clinical examination, ultrasonography, magnetic resonance imaging, and other techniques. Fertil Steril. 2017;108:886-94. 7 Leyendecker G, Kunz G, Wildt L, et al. Uterine hyperperistalsis and dysperistalsis as dysfunctions of the mechanism of rapid sperm transport in patients with endometriosis and infertility. Hum Reprod. 1996;11:1542-51. Publication Dates Publication in this collection 11 Aug 2023 Date of issue 2023 This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Authorship .author-card { border-bottom: 1px solid #ccc; padding: 1rem 0; } .author-card:last-child { border-bottom: 0px; } .author-name { font-weight: 600; } .orcid-button { padding-left: 2.5rem; } .modal-body { padding-bottom: 3rem; } .orcid-button::before { content: ""; position: absolute; background-image: url(https://ds.scielo.org/img/logo-orcid.svg); background-repeat: no-repeat; background-size: 1.5em auto; background-position: .5em center; display: block; width: 60px; height: 60px; top: -10px; left: 0; } person Luís Ronan Marquez Ferreira de Souza school Associate Professor of Radiology at the Universidade Federal do Triângulo Mineiro, Coordinator of the Female Pelvic Imaging Sector of the Colégio Brasileiro de Radiologisa e Diagnóstico por Imagem Universidade Federal do Triângulo Mineiro Associate Professor of Radiology at the Universidade Federal do Triângulo Mineiro, Coordinator of the Female Pelvic Imaging Sector of the Colégio Brasileiro de Radiologisa e Diagnóstico por Imagem 0000-0002-4634-8972 person Patricia Prando Cardia school Radiologist and Coordinator of the Program for Medical Residency and Improvement in Radiology at the Hospital Vera Cruz and the Hospital da Pontifícia Universidade Católica de Campinas Universidade Católica de Campinas Radiologist and Coordinator of the Program for Medical Residency and Improvement in Radiology at the Hospital Vera Cruz and the Hospital da Pontifícia Universidade Católica de Campinas 0000-0002-6694-1482 SCIMAGO INSTITUTIONS RANKINGS Associate Professor of Radiology at the Universidade Federal do Triângulo Mineiro, Coordinator of the Female Pelvic Imaging Sector of the Colégio Brasileiro de Radiologisa e Diagnóstico por Imagem Universidade Federal do Triângulo Mineiro Associate Professor of Radiology at the Universidade Federal do Triângulo Mineiro, Coordinator of the Female Pelvic Imaging Sector of the Colégio Brasileiro de Radiologisa e Diagnóstico por Imagem Radiologist and Coordinator of the Program for Medical Residency and Improvement in Radiology at the Hospital Vera Cruz and the Hospital da Pontifícia Universidade Católica de Campinas Universidade Católica de Campinas Radiologist and Coordinator of the Program for Medical Residency and Improvement in Radiology at the Hospital Vera Cruz and the Hospital da Pontifícia Universidade Católica de Campinas How to cite link copy function currentDate() { var today = new Date(); var months = ['January', 'February', 'March', 'April', 'May', 'June', 'July', 'August', 'September', 'October', 'November', 'December'] today.setTime(today.getTime()); return today.getDate() + " " + months[today.getMonth()] + " " + today.getFullYear(); } var citation = 'Souza, Luís Ronan Marquez Ferreira de and Cardia, Patricia Prando. 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