Fiber tracking of the sacral nerves in female pelvis: a potential method to evaluate endometriosis-related fibres alteration?

Pelvis, Genital / Reproductive system female, MR Authors: L. Manganaro, V. Vinci, F. Fierro, P. Lodise, M. E. Sergi, S. Bernardo, G. Vittori, M. G. Porpora, M. Marini; Rome/IT DOI: 10.1594/ecr2012/C-1201 Purpose Our study aimed to evaluate the feasibility of tractoghraphy to study sacral nerves in women affected by pelvic endometriosis associated to crhonic pelvic pain.

and Materials We enrolled 2 groups of patient:30 women came with US diagnosis of endometriosis and had an important clinical history of pelvic pain; and a control-group of 10 women. Operating on 3T MRI, we reconstructed nervous pathway by postprocessing the DTI images with speficic software . Radiologists made two different kind of evaluation: -quantitative analysis: by evaluation of the 3D architecture of nervous pathways reconstructed by software, radiologists mainly considered fibres length and branches morphology. -qualitative analysis: considering values of Fractional Anisotropy (FA) For what concern...

Results concerning Tractography can be divided into two main branches, concerning the 3D architecture of nervous pathways andsecondly, not for importance, the fractional anisotropy. According to this analysis, it resulted that all 10 volunteers patients were included in 1st class. On the contrary, the 30 positive patients were distributed in the three classes differently as follows: 22/30 patients in 3rd class 6/30 patients in 2nd class 2/30 patients in 1st class Most of patients included in 3rd class presented numerous branches (more than 6) with...

Various studies demonstrated the correlation between endometriosis and alterated pelvic innervations; moreover, in particular cases some studies suggest nerve-sparing surgery in order to reduce women’s symptons. In agreement with these, in our preliminary experience the comparison between the two group demontrated a difference in the nervous pathways with significant alteration in case of posterior compartments implants localization; moreover Tractography revealed to be diriment to detect nerves alteration and represent the only non-invasive way to study nervous pathways; therefore, in next future it may be useful...

C. Khalil ∗, J.F. Budzik, E. Kermarrec, V. Balbi, V. Le Thuc, A. Cotten. Tractography of peripheral nerves and skeletal muscles. European Journal of Radiology 76 (2010) 391–397 Hiltunen J, Suortti T, Arvela S, Seppa M, Joensuu R, Hari R. Diffusion tensor imaging and tractography of distal peripheral nerves at 3 T. Clin Neurophysiol 2005;116(10):2315–23 Fauconnier A, Chapron C, Dubuisson JB, Vieira M, Dousset B, Breart G. Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril 2002;78:719 –26 Imaging delle...