Junctional zone thickness in young nulliparous women according to menstrual cycle and hormonal contraception use.

This prospective study aims to determine the optimal menstrual phase and uterine location to detect the thickest junctional zone by magnetic resonance imaging (MRI). Healthy nulliparous women were subdivided according to their use of hormonal contraception. Each women was investigated three times during their menstrual cycle. Eighteen nulliparous non-users and 29 nulliparous users of hormonal contraception (mean age 26.4 and 25.8 years, respectively) underwent a pelvic MRI (1.5T) examination during the follicular, ovulatory and luteal phase. The junctional zone thickness was measured at six locations in the uterine wall. A significantly thinner junctional zone was observed at the anterior and posterior wall of the midcorpus (P = 0.01 and P = 0.004 respectively) and fundus (P = 0.009 and P = 0.023 respectively), in the contraception users compared with the non-users. No differences in junctional zone thickness were noticed between the menstrual phases and the uterine wall locations. The ratio of junctional zone versus total myometrial thickness was also different between both groups and between the assessed uterine locations. To conclude, any phase in the menstrual cycle and location within the uterine wall was validated to determine the junctional zone thickness on MRI, although the fundal location is preferred.

Meylaerts LJ ，Wijnen L ，Grieten M ，Palmers Y ，Ombelet W ，Vandersteen M ... -  《-》

Perfusion of the uterine junctional zone in nulliparous and primiparous women assessed by DCE-MRI, as a function of menstrual cycle and hormonal contraception.

To evaluate the perfusion parameters of inner and outer myometrium in healthy nulliparous and primiparous women who are and who are not currently using hormonal contraceptives by means of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). We performed pelvic 1.5T DCE-MRI on 98 women: 18 nulliparous non-users, 30 nulliparous users, 12 primiparous non-users and 38 primiparous users of hormonal contraception (mean age respectively 26.4, 25.8, 30.23 and 28.18years). The nulliparous non-users underwent DCE-MRI investigations during their follicular, ovulatory and luteal phase. Perfusion parameters (iAUC/volume, Ktrans, Kep and Ve) were assessed in the anterior and posterior junctional zone (JZ), outer myometrium and cervix. In nulliparous non-users, the mean Ktrans and iAUC/volume showed a decrease from follicular to luteal phase (0.82 vs 0.55min-1 for Ktrans, p=0/027 and 1.28 vs 0.68 for iAUC/volume, p<0.001). The anterior JZ demonstrated lower Ktrans (p=0.050) and higher Kep (p=0.012), in nulliparous non-users, lower Ktrans in nulliparous users (p<0.001) and lower Ve in primiparous users (p=0.012) than the anterior outer myometrium. Ktrans at the anterior and posterior JZ wall in nulliparous users was lower than in non-users (p=0.001 and p=0.013) and Ve at the anterior JZ wall in primiparous users was lower than in non-users (p=0.044). This study provides data on normal perfusion parameters of inner and outer myometrium, which may be potentially useful in assisted reproductive therapy.

Meylaerts LJ ，Wijnen L ，Bazot M ，Grieten M ，Ombelet W ，Vandersteen M ... -  《-》

Uterine junctional zone thickness in infertile women evaluated by MRI.

To prospectively evaluate and compare the junctional zone (JZ) and outer myometrial thickness in infertile and healthy nulliparous women at different locations in the uterine wall during the menstrual cycle by magnetic resonance imaging (MRI). We performed pelvic 1.5T MRI (T2 -weighted turbo spin echo sequences) on 28 infertile women: 5 with infertility of unknown origin, 12 anovulating, and 11 on ovarian stimulation therapy (mean age 28.5, 30.8, and 29.3 years, respectively); and a control group consisting of 18 healthy nulliparous volunteers (mean age 26.4 years). The women with unknown infertility origin and the control group underwent MRI investigations during their follicular, ovulatory, and luteal phase. The JZ and outer myometrial thicknesses were measured at six locations in the uterine wall: anterior and posterior wall of the isthmus, midcorpus, and fundus. The JZ in the anovulating women at the posterior wall of the isthmus (4.2 mm) was significantly thicker compared to the control group (3.2, 3.0, and 2.9 mm, in respectively the three menstrual phases) (P = 0.027). The outer myometrium in the anovulating women was significantly thicker at all measured locations (average 11.5 mm) in comparison to the control group (8.1, 8.0, and 8.5 mm, in respectively the three menstrual phases) (P < 0.050). The infertile women on ovarian stimulation therapy showed a significantly thicker outer myometrium at the anterior wall (isthmus, midcorpus, and fundus) (P < 0.050). The results indicate that a thickened JZ, and especially a thickened outer myometrium, might be associated with infertility. 1 J. Magn. Reson. Imaging 2017;45:926-936.

Meylaerts LJ ，Wijnen L ，Ombelet W ，Bazot M ，Vandersteen M ... -  《-》

Cyclic changes of the junctional zone on 3 T MRI images in young and middle-aged females during the menstrual cycle.

To evaluate the cyclic changes of the junctional zone in different age groups during the menstrual cycle using 3 T magnetic resonance imaging (MRI), and to investigate the correlation with basic female hormone levels. Thirty-eight normal volunteers (age range, 20-40 years; mean age, 29 years: 20-30 years, n=22; 31-40 years, n=16) with regular menstrual cycles underwent a pelvic 3 T MRI examination on the 2nd or 3rd days of their menstrual phase (MP), follicular phase (FP), peri-ovulatory phase (OP), and luteal phase (LP), respectively, including a T2-weighted three-dimensional (3D) turbo spin-echo (TSE) with variable flip angle ("SPACE") sequence, a T2-weighted mapping sequence, and diffusion tensor imaging (DTI). The thickness, T2, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) values of the junctional zone on mid-sagittal images were separately measured by two radiologists on the post-processed workstation. The linear mixed model and one-way analysis of variance were used to evaluate the differences between the two age groups during the four phases. The serum levels of oestradiol (E), progesterone (P), luteinising hormone (LH), and follicle-stimulating hormone (FSH) were measured during the MP and compared with anatomical and functional MRI values using Pearson's correlation analysis. The thickness of the anterior and posterior junctional zone increased with age (p<0.05). In the 20-30 year age group, during the MP the junctional zone was significantly thicker than at the other three phases (p<0.05). Serum E levels correlated moderately with variation in thickness during the menstrual cycle. In the 30-40 year age group, no statistical difference in the thickness was found during the menstrual cycle. As age increased, the ADC values of the junctional zone decreased (p=0.02). In both groups, the ADC and T2 values of the junctional zone showed significant differences between the MP and LP (p<0.05), whereas no statistical difference in FA values were found during the menstrual cycle. Serum E, P, and LH levels correlated moderately with variation of ADC and T2 values during the menstrual cycle. The thickness and ADC values of the junctional zone showed significant differences between the two age groups. Cyclic changes in the thickness, ADC, and T2 values of the junctional zone were found during the menstrual cycle, which correlated moderately with the serum female hormone levels.

He YL ，Ding N ，Li Y ，Li Z ，Xiang Y ，Jin ZY ，Xue HD ... -  《-》

The normal uterus on magnetic resonance imaging and variations associated with the hormonal state.

Bartoli JM ，Moulin G ，Delannoy L ，Chagnaud C ，Kasbarian M ... -  《SURGICAL AND RADIOLOGIC ANATOMY》