Magnetic resonance imaging for non-invasive diagnosis of various forms of endometriosis in women with infertility

BACKGROUND: Endometriosis is one of the most common causes of infertility, affecting approximately 6%10% of women of reproductive age. For many decades, laparoscopic surgery has been considered the gold standard for diagnosing various forms of endometriosis. However, diagnostic laparoscopy, despite its widespread use, is an invasive and expensive procedure with certain risks. Current scientific literature increasingly shows that the methods of radiological diagnosis (ultrasound and magnetic resonance imaging [MRI]) are the main and most promising for verification of endometriosis. The advantages of MRI over ultrasound are multiplanar images, high tissue contrast, and smaller size of detectable heterotopias. AIM: To assessing the sensitivity and specificity of MRI for diagnosing different forms of endometriosis. METHODS: A retrospective analysis of the medical histories and instrumental studies of 129 women of reproductive age (mean age of the participants was 30.54.6 years) with a clinical diagnosis of infertility and suspected genital endometriosis was conducted. At the first stage of the study, the patients underwent a comprehensive MRI with one-stage magnetic resonance hysterosalpingography to assess the pelvis and tubal patency. Further, laparoscopic surgery (LS) was performed to confirm/refute the diagnosis of genital endometriosis, provide surgical treatment, or further search for possible causes of infertility. The results obtained with MRI and LS were compared, and the sensitivity and specificity of MRI for diagnosing external and internal genital endometriosis were assessed. RESULTS: According to the data obtained, the specificity of MRI for diagnosing peritoneal endometriosis was 74% (95% confidence interval [CI], 57%85%), and the sensitivity was 94% (95% CI, 87%99%). Diagnostic accuracy of the technique was 86% (95% CI, 79%91%). The most frequent localization of endometrioid heterotopias was retrocervical (41%). The specificity of this technique for diagnosing endometrioid ovarian cysts was 92% (95% CI, 82%97%), and the sensitivity amounted for 98% (95% CI, 90%100%). Diagnostic accuracy of the technique was 94% (95% CI, 88%96%). The specificity and sensitivity of MRI for the diagnosis of adenomyosis were 96% (95% CI, 92%99%) and 99% (95% CI, 87%100%), respectively. Diagnostic accuracy of the technique was 97% (95% CI, 93%99%). Our results were consistent with the literature data on the accuracy of MRI for diagnosing endometriosis. CONCLUSIONS: Based on the results, MRI is a promising non-invasive method for diagnosing various forms of endometriosis. The performance of a comprehensive MRI allows obtaining sufficiently accurate information about the condition of the pelvic organs, detecting the manifestations of genital endometriosis, and reducing the time for examining women with infertility

Trace Amine-Associated Receptor 5 Provides Olfactory Input Into Limbic Brain Areas and Modulates Emotional Behaviors and Serotonin Transmission

Trace amine-associated receptors (TAARs) are a class of G-protein-coupled receptors found in mammals. While TAAR1 is expressed in several brain regions, all the other TAARs have been described mainly in the olfactory epithelium and the glomerular layer of the olfactory bulb and are believed to serve as a new class of olfactory receptors sensing innate odors. However, there is evidence that TAAR5 could play a role also in the central nervous system. In this study, we characterized a mouse line lacking TAAR5 (TAAR5 knockout, TAAR5-KO) expressing beta-galactosidase mapping TAAR5 expression. We found that TAAR5 is expressed not only in the glomerular layer in the olfactory bulb but also in deeper layers projecting to the limbic brain olfactory circuitry with prominent expression in numerous limbic brain regions, such as the anterior olfactory nucleus, the olfactory tubercle, the orbitofrontal cortex (OFC), the amygdala, the hippocampus, the piriform cortex, the entorhinal cortex, the nucleus accumbens, and the thalamic and hypothalamic nuclei. TAAR5-KO mice did not show gross developmental abnormalities but demonstrated less anxiety- and depressive-like behavior in several behavioral tests. TAAR5-KO mice also showed significant decreases in the tissue levels of serotonin and its metabolite in several brain areas and were more sensitive to the hypothermic action of serotonin 5-HT1A receptor agonist 8-hydroxy-2-(di- n -propilamino)tetralin (8-OH-DPAT). These observations indicate that TAAR5 is not just innate odor-sensing olfactory receptor but also serves to provide olfactory input into limbic brain areas to regulate emotional behaviors likely via modulation of the serotonin system. Thus, anxiolytic and/or antidepressant action of future TAAR5 antagonists could be predicted. In general, “olfactory” TAAR-mediated brain circuitry may represent a previously unappreciated neurotransmitter system involved in the transmission of innate odors into emotional behavioral responses