Amenorrhea MRI: Difference between revisions

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{{Amenorrhea}}
{{Amenorrhea}}


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==Overview==
==Overview==
There are no [[MRI]] findings associated with amenorrhea. However, a [[MRI]] may be helpful in the [[diagnosis]] of the [[diseases]] that can cause amenorrhea, such as [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]], [[androgen insensitivity syndrome]], anatomic [[genital]] defects, and also [[pituitary adenoma]].


==MRI==
==MRI==
* [[Brain]] [[MRI]] may be helpful in the diagnosis of delayed [[puberty]]. Findings on [[MRI]] suggestive of delayed [[puberty]] include:<ref name="pmid26194704">{{cite journal |vauthors=Boehm U, Bouloux PM, Dattani MT, de Roux N, Dodé C, Dunkel L, Dwyer AA, Giacobini P, Hardelin JP, Juul A, Maghnie M, Pitteloud N, Prevot V, Raivio T, Tena-Sempere M, Quinton R, Young J |title=Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment |journal=Nat Rev Endocrinol |volume=11 |issue=9 |pages=547–64 |year=2015 |pmid=26194704 |doi=10.1038/nrendo.2015.112 |url=}}</ref>
* There are no [[MRI]] findings associated with amenorrhea. However, a [[MRI]] may be helpful in the [[diagnosis]] of the [[diseases]] that can cause amenorrhea, such as [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]], [[androgen insensitivity syndrome]], anatomic [[genital]] defects, and also [[pituitary adenoma]].
{| align="right"
| [[image:Webp.net-gifmaker (80).gif|thumb|500px|Polycystic ovary syndrome (PCOS) - Case courtesy of Dr Ahmed Mahrous Saied, Via Radiopaedia.org<ref>Radiopaedia.org. From the case <"https://radiopaedia.org/cases/32857">rID: 32857</ref>]]
|- |
| [[image:Webp.net-gifmaker (90).gif|thumb|500px|Intra-abdominal testes in androgen insensitivity syndrome - Case courtesy of Dr Dalia Ibrahim, Via Radiopaedia.org<ref>Radiopaedia.org. From the case <"https://radiopaedia.org/cases/29208">rID: 29208</ref>]]
|- |
| [[image:Webp.net-gifmaker (70).gif|thumb|500px|Transverse vaginal septum - Case courtesy of Dr Praveen Jha, Via Radiopaedia.org<ref>Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16198">rID: 16198</ref>]]
|}
=== Polycystic ovary syndrome (PCOS) ===
*Rotterdam criteria is diagnostic of [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]]. Rotterdam criteria uses ultrasound findings which include:<ref name="pmid14714587">{{cite journal |vauthors=Balen AH, Laven JS, Tan SL, Dewailly D |title=Ultrasound assessment of the polycystic ovary: international consensus definitions |journal=Hum. Reprod. Update |volume=9 |issue=6 |pages=505–14 |year=2003 |pmid=14714587 |doi= |url=}}</ref>
**Detecting 25 or more [[Follicle|follicles]]<ref name="pmid23503943">{{cite journal |vauthors=Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR |title=Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume |journal=Hum. Reprod. |volume=28 |issue=5 |pages=1361–8 |year=2013 |pmid=23503943 |doi=10.1093/humrep/det062 |url=}}</ref>
**Detecting increased [[ovarian]] volume > 10 cm<sup>3</sup>
**Peripheral arrangement of cysts
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===Androgen insensitivity syndrome===
*Findings on an [[MRI]] suggestive of [[androgen insensitivity syndrome]] include:<ref name="TankKnoll2015">{{cite journal|last1=Tank|first1=Jay|last2=Knoll|first2=Abraham|last3=Gilet|first3=Anthony|last4=Kim|first4=Susanne|title=Imaging characteristics of androgen insensitivity syndrome|journal=Clinical Imaging|volume=39|issue=4|year=2015|pages=707–710|issn=08997071|doi=10.1016/j.clinimag.2015.02.002}}</ref>
**Bilateral [[cryptorchidism]]
**Juxta-[[testicular]] [[Mullerian duct]] cysts
**Absent or rudimentary [[uterus]]
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==='''Anatomic genital defects'''===
*Findings on an [[MRI]] suggestive of [[imperforate hymen]] include:<ref name="pmid21686660">{{cite journal| author=Lardenoije C, Aardenburg R, Mertens H| title=Imperforate hymen: a cause of abdominal pain in female adolescents. | journal=BMJ Case Rep | year= 2009 | volume= 2009 | issue=  | pages=  | pmid=21686660 | doi=10.1136/bcr.08.2008.0722 | pmc=3029536 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21686660  }}</ref>
**Hypoechoic mass in the [[vagina]] ([[hematocolpos]]) and enlarged [[uterus]] ([[haematometra]])
**Normal [[ovaries]]
*Findings on an [[MRI]] suggestive of transverse [[vaginal septum]] include:
**[[Bicornuate uterus]]
**[[Hematocolpos]]
**[[Hematometra]]
**[[Hematosalpinx]]
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=== Pituitary adenoma ===
* [[Brain]] [[MRI]] may be helpful in the diagnosis of the cause of amenorrhea. Findings on [[MRI]] suggestive of amenorrhea include:<ref name="pmid26194704">{{cite journal |vauthors=Boehm U, Bouloux PM, Dattani MT, de Roux N, Dodé C, Dunkel L, Dwyer AA, Giacobini P, Hardelin JP, Juul A, Maghnie M, Pitteloud N, Prevot V, Raivio T, Tena-Sempere M, Quinton R, Young J |title=Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment |journal=Nat Rev Endocrinol |volume=11 |issue=9 |pages=547–64 |year=2015 |pmid=26194704 |doi=10.1038/nrendo.2015.112 |url=}}</ref>
** [[Hypothalamus|Hypothalamo]]-[[pituitary]] lesions
** [[Hypothalamus|Hypothalamo]]-[[pituitary]] lesions
** [[Aplasia]] of [[olfactory bulb]] and/or [[Sulci (anatomy)|sulci]] ([[Kallmann syndrome]])
** [[Optic nerve]] compression ([[pituitary adenoma]])
** [[Optic nerve]] compression ([[pituitary adenoma]])
** [[Inner ear]] abnormalities ([[CHARGE syndrome]])
** [[Inner ear]] abnormalities ([[CHARGE syndrome]])
* [[Brain]] [[MRI]] is indicated in patients with delayed [[puberty]], experiencing some alarm signs, such as [[headache]], [[visual impairment]], and behavioral changes.
* [[Brain]] [[MRI]] is indicated in patients with amenorrhea, experiencing some alarm signs, such as [[headache]], [[visual impairment]], and behavioral changes.
* Showing the [[aplasia]] of [[olfactory bulbs]] and/or [[Sulci (anatomy)|sulci]] in [[MRI]], it is assumed as differentiation of [[Kallmann syndrome]] from isolated [[hypogonadotropic hypogonadism]], in patient without smelling problems or hard to evaluate.<ref name="PalmertDunkel2012">{{cite journal|last1=Palmert|first1=Mark R.|last2=Dunkel|first2=Leo|title=Delayed Puberty|journal=New England Journal of Medicine|volume=366|issue=5|year=2012|pages=443–453|issn=0028-4793|doi=10.1056/NEJMcp1109290}}</ref>
* A moderate agreement is seen between the smell identification test (UPSIT) and presence of the [[olfactory bulbs]] in [[MRI]], in patients with [[hypogonadotropic hypogonadism]]. While, there is a good agreement between them in absence of the [[olfactory bulbs]] in [[MRI]] and [[anosmia]].<ref name="pmid6694486">{{cite journal |vauthors=Doty RL, Shaman P, Kimmelman CP, Dann MS |title=University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic |journal=Laryngoscope |volume=94 |issue=2 Pt 1 |pages=176–8 |year=1984 |pmid=6694486 |doi= |url=}}</ref><ref name="PalmertDunkel2012" />


<gallery align="left">
<gallery align="left">
image:Pituitary-adenoma-1.jpg|thumb|300px|Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref>
image:Pituitary-adenoma-1.jpg|thumb|300px|Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard, Via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref>
image:Hypothalamic-hamartoma.jpeg|thumb|300px|Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref>
image:Hypothalamic-hamartoma.jpeg|thumb|300px|Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard, Via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890</ref>
image:Pituitary-macroadenoma-non-functioning-null-cell (1).jpg|thumb|300px|Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/5562">rID: 5562</ref>
image:Pituitary-macroadenoma-non-functioning-null-cell (1).jpg|thumb|300px|Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard, Via Radiopaedia.org<ref name="https://radiopaedia.org/">Radiopaedia.org. From the case <"https://radiopaedia.org/cases/5562">rID: 5562</ref>
</gallery>
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==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Latest revision as of 20:22, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

There are no MRI findings associated with amenorrhea. However, a MRI may be helpful in the diagnosis of the diseases that can cause amenorrhea, such as polycystic ovary syndrome (PCOS), androgen insensitivity syndrome, anatomic genital defects, and also pituitary adenoma.

MRI

Polycystic ovary syndrome (PCOS) - Case courtesy of Dr Ahmed Mahrous Saied, Via Radiopaedia.org[1]
Intra-abdominal testes in androgen insensitivity syndrome - Case courtesy of Dr Dalia Ibrahim, Via Radiopaedia.org[2]
Transverse vaginal septum - Case courtesy of Dr Praveen Jha, Via Radiopaedia.org[3]

Polycystic ovary syndrome (PCOS)



















Androgen insensitivity syndrome



















Anatomic genital defects



















Pituitary adenoma

  • Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard, Via Radiopaedia.org[9]

    Pituitary adenoma - Case courtesy of A.Prof Frank Gaillard, Via Radiopaedia.org[9]

  • Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard, Via Radiopaedia.org[9]

    Hypothalamic lesion - Case courtesy of A.Prof Frank Gaillard, Via Radiopaedia.org[9]

  • Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard, Via Radiopaedia.org[9]

    Pituitary non-functioning macroadenoma - Case courtesy of A.Prof Frank Gaillard, Via Radiopaedia.org[9]

References

  1. ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/32857">rID: 32857
  2. ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/29208">rID: 29208
  3. ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16198">rID: 16198
  4. ↑ Balen AH, Laven JS, Tan SL, Dewailly D (2003). "Ultrasound assessment of the polycystic ovary: international consensus definitions". Hum. Reprod. Update. 9 (6): 505–14. PMID 14714587.
  5. ↑ Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR (2013). "Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume". Hum. Reprod. 28 (5): 1361–8. doi:10.1093/humrep/det062. PMID 23503943.
  6. ↑ Tank, Jay; Knoll, Abraham; Gilet, Anthony; Kim, Susanne (2015). "Imaging characteristics of androgen insensitivity syndrome". Clinical Imaging. 39 (4): 707–710. doi:10.1016/j.clinimag.2015.02.002. ISSN 0899-7071.
  7. ↑ Lardenoije C, Aardenburg R, Mertens H (2009). "Imperforate hymen: a cause of abdominal pain in female adolescents". BMJ Case Rep. 2009. doi:10.1136/bcr.08.2008.0722. PMC 3029536. PMID 21686660.
  8. ↑ Boehm U, Bouloux PM, Dattani MT, de Roux N, Dodé C, Dunkel L, Dwyer AA, Giacobini P, Hardelin JP, Juul A, Maghnie M, Pitteloud N, Prevot V, Raivio T, Tena-Sempere M, Quinton R, Young J (2015). "Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment". Nat Rev Endocrinol. 11 (9): 547–64. doi:10.1038/nrendo.2015.112. PMID 26194704.
  9. ↑ 9.0 9.1 9.2 Radiopaedia.org. From the case <"https://radiopaedia.org/cases/16890">rID: 16890

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