Avaliação da contratilidade uterina pela Cine-Ressonância em mulheres com e sem endometriose profunda infiltrativa

Abstract

Endometriosis is a significant cause of infertility, but the mechanism that causes this relationship is still being studied. The objective of this study was to evaluate uterine function by visualizing the contractile movements of the uterus using Cine Magnetic Resonance images (Cine MRI) in patients with and without deep infiltrating endometriosis (with or without associated adenomyosis). The study sample comprised 43 women between 18 and 45 years old, with 18 women in the case group (deep infiltrating endometriosis) and 25 women in the control group (without deep endometriosis). The Cine MRI was performed using a 3.0T magnet and was then analyzed at 12× faster than real speed, focusing on the presence, direction and frequency of uterine peristalsis. Uterine peristalsis, in the periovulatory phase, was identified in more patients in the endometriosis group than in the control group. In addition, the frequency of peristaltic waves was also higher in the endometriosis group than in controls in the periovulatory and luteal phase. However the differences were not statistically significant. In patients with adenomyosis, a significant reduction in the frequency of peristalsis was observed during the first phase of the menstrual cycle (p <0.05). The frequency of uterine peristalsis appears to be increased during the periovulatory and luteal phase in patients with deep infiltrating endometriosis, and significantly reduced in patients with adenomyosis during the first phase of the menstrual cycle, both effects having the potential to negatively interfere with sperm transport and the early stages of fertilization.