Evolution of adenomyosis and deep pelvic endometriosis lesions before and after pregnancy on magnetic resonance imaging: a single-center cohort of 139 patients ; Évolution des lésions d’adénomyose et d’endométriose pelvienne profonde avant et après grossesse en imagerie par résonnance magnétique : cohorte unicentrique de 139 patientes

Background: adenomyosis and endometriosis are chronic benign hormone-dependent disorders. They are defined as the presence of ectopic endometrial tissue, within myometrium for adenomyosis and outside of the uterus for endometriosis. These conditions are often associated with chronic pelvic pain, abnormal uterine bleeding or fertility disorders. The natural course of adenomyosis and endometriosis is still unclear and depends on several factors : hormonal treatment, pregnancy or surgery. Pregnancy is considered to have a positive impact on symptoms and evolution of endometriosis by decidualization of endometrium. While available data evaluating the effect of pregnancy on adenomyosis are lacking. Objective: the aim of this study is to compare the evolution of diffuse adenomyosis, focal adenomyosis, deep infiltrating endometriosis and endometriomas, before and after pregnancy, based on stringent magnetic resonance imaging criteria. Materials and Methods: between January 1st 2010 and September 30th 2020, all patients followed in your referral care center for symptomatic adenomyosis and/or endometriosis, diagnosed on MRI and without prior history of surgery were included. They had to give birth after 24+0. For each patient, pelvic magnetic resonance imaging pre- and post-pregnancy were performed by a single experienced radiologist with the same protocol, based on stringent validated criteria. The aim outcome is to compare the rate of diffuse adenomyosis and focal adenomyosis, the volume of focal adenomyosis before and after pregnancy on MRI. The secondary outcomes are to compare the mean volume of nodule endometriosis, size of endometriomas before and after pregnancy on MRI and the evolution of each lesion, according to RECIST 1.1 criteria and the mean time interval between delivery and MRI. Results: among 139 patients analyzed, 22 (15.8%) presented diffuse adenomyosis, 55 (39.6%) focal adenomyosis and 19 (13.7%) both of them. The rate of diffuse adenomyosis was significantly higher after pregnancy on MRI (n= 22 ...