Uterine peristalsis of adenomyosis patients on cine magnetic resonance imaging

Aki Kido, Ohta I, Ikuko Ohta, Yuki Himoto, Shinya Fujii, Kyo Noguchi, Yuji Nakamoto, Toshihide Ogawa
International Journal of Gynecology & Obstetrics · 2025 · vol. 170(1) , pp. 242–249 · doi:10.1002/ijgo.70002 · PMID:39927852 · W4407348973
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Cine MRI revealed uterine peristalsis occurred more frequently in adenomyosis lesions than normal myometrium, especially during the luteal phase, with characteristic movements observed in about half of patients.

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Abstract

OBJECTIVE: Adenomyosis, a common gynecologic disease, can cause infertility. Uterine peristalsis (UP) is a wave-like contraction. Abnormal UP has been linked to infertility. The aim of this study using magnetic resonance imaging (MRI) was to compare UP between uterine walls with adenomyosis and normal walls to ascertain the possible effects of adenomyosis on UP. METHODS: Using cine MRI, UP of 139 adenomyosis patients were evaluated. The uterine walls were divided into those with and without lesions. One radiologist evaluated the presence of UP depending on the menstrual cycle phase. In cases where peristalsis was present, the peristaltic frequency and direction were evaluated. For uterine walls with adenomyosis, characteristic movement of peristalsis was evaluated, including low signal conduction, change of endometrial configuration, and irregular signal change. Peristalsis was evaluated further between focal and diffuse adenomyosis. RESULTS: UP was observed significantly more in adenomyosis lesions (113/182) than in normal myometrium (47/96), especially in the luteal phase, but the frequency was not significantly different (6.9 vs. 7.3). Comparison between diffuse adenomyosis and focal adenomyosis revealed that the presence of peristalsis was not significantly different in any cycle phase. Peristaltic direction was observed as cervix-to-fundus in the proliferative and luteal phase. Almost half of the cases showed low signal conduction (48%-59%), change of endometrial configuration (31%-53%), and irregular signal change (41%-56%) in adenomyosis lesions. CONCLUSION: UP in adenomyosis showed a tendency of hyperperistalsis in the luteal phase. It accompanies characteristic peristaltic movement in adenomyosis in about half of patients.
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Abstract

Objective Adenomyosis, a common gynecologic disease, can cause infertility. Uterine peristalsis (UP) is a wave-like contraction. Abnormal UP has been linked to infertility. The aim of this study using magnetic resonance imaging (MRI) was to compare UP between uterine walls with adenomyosis and normal walls to ascertain the possible effects of adenomyosis on UP.

Methods

Using cine MRI, UP of 139 adenomyosis patients were evaluated. The uterine walls were divided into those with and without lesions. One radiologist evaluated the presence of UP depending on the menstrual cycle phase. In cases where peristalsis was present, the peristaltic frequency and direction were evaluated. For uterine walls with adenomyosis, characteristic movement of peristalsis was evaluated, including low signal conduction, change of endometrial configuration, and irregular signal change. Peristalsis was evaluated further between focal and diffuse adenomyosis.

Results

UP was observed significantly more in adenomyosis lesions (113/182) than in normal myometrium (47/96), especially in the luteal phase, but the frequency was not significantly different (6.9 vs. 7.3). Comparison between diffuse adenomyosis and focal adenomyosis revealed that the presence of peristalsis was not significantly different in any cycle phase. Peristaltic direction was observed as cervix-to-fundus in the proliferative and luteal phase. Almost half of the cases showed low signal conduction (48%–59%), change of endometrial configuration (31%–53%), and irregular signal change (41%–56%) in adenomyosis lesions.

Conclusion

UP in adenomyosis showed a tendency of hyperperistalsis in the luteal phase. It accompanies characteristic peristaltic movement in adenomyosis in about half of patients. CONFLICT OF INTEREST STATEMENT The authors do not have any conflict of interest. DATA AVAILABILITY STATEMENT Research data are not shared.

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Condition tags

adenomyosisinfertility

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (12)

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