Analysis of physiological and clinical significance of uterine contractions

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The uterus has inherent contractility, and the inner myometrium is subjeci to subtle wave-like movements, which is called uterine peristalsis. It has been supposed to be involved into uterine functions including sperm transport or menstrual blood discharge, but is has not been well documented. Our purpose is to display this movement clearly on MR imaging that has excellent tissue contrast, and to elucidate the role of uterine peristalsis using cine MR imaging.During the first year of the research period, we mainly worked to develop the methods to display uterine peristalsis by means of MR imaging. Cine mode display of ultrafast MRl was capable of showing uterine peristalsis. Comparison of MR imaging with US has lead to the conclusion that MR imaging better demonstrated uterine peristalsis. Our results showed that uterine peristalsis and the junctional zone had close relationship. The second year of the research, we have added studies in women of perimenopausal period, studies to evaluate variations of uterine peristalsis during a day, relationship between dysmenorrhea and peristalsis. The direction and incidence of peristalsis varied according to menstrual cycle phases. The predominant direction was cervico-fundal during the periovulatory phase and fundocervical during the menstrual phase. Peristalsis subsided during the luteal phase. These directions were important in sperm transport, discharge of menstrual blood, and conservation of early pregnancies. Since disorders in peristalsis are hypothesized to be the causes of a variety of clinical symptoms such as dysmenorrhea, ultrafast MRl appears to be a powerful tool to elucidate the functions of the uterus.