Relationship between Magnetic Resonance Relaxometry R2 Value and Iron Levels and the Severity of Dysmenorrhea in Patients with Ovarian Endometrioma

Abstract

Objective: Magnetic resonance (MR) relaxometry is a diagnostic imaging method that enables non-invasive quantification of iron levels in patients with endometriosis. The aim of this study is to investigate whether cyst fluid (CF) MR relaxometry R2 values are associated with iron levels and the severity of dysmenorrhea in women with ovarian endometrioma (OMA).

Methods: A single-center prospective cohort study was conducted by collecting data from patients admitted to the Department of Gynecology, Nara Medical University Hospital, Kashihara, Japan, from February 2013 to July 2019. Fifty patients aged 21-54 years who were histologically diagnosed with OMA were enrolled. CF R2 values were measured preoperatively using MR relaxometry. The severity of dysmenorrhea was classified into four groups based on the Numeric Rating Scale (NRS-11): painless, mild, moderate, and severe. The association between clinicopathological features and CF iron levels and R2 values was analyzed.

Results: The mean (± SD) age of women was 36.58 ± 7.16 years. The mean CF R2 value was 23.83 ± 10.16 s-1. There were no significant differences among the four groups in variables regarding age at diagnosis, parity, preoperative serum CA125 and CA19-9 levels, tumor diameter, and tumor localization (unilateral or bilateral). CF iron levels were significantly correlated with the severity of dysmenorrhea (P=0.001). A significant positive correlation between preoperative CF R2 value and iron level was detected (r = 0.608, P=0.001). However, there was no significant correlation between R2 values and the severity of dysmenorrhea.

Conclusion: R2 values showed a significant positive correlation with iron levels, but were not associated with the severity of dysmenorrhea.