Objectives: To determine whether diffusion-weighted magnetic resonance imaging (DWMRI), a noninvasive procedure, can contribute to the diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC). Methods: The pelvic DWMRI of patients with chronic pelvic pain syndrome was selected between January 2012 and June 2017. A radiologist analyzed the bladder wall signal; he was blinded to the patients’ clinical data. According to the 2008 European Society for the Study of Bladder Pain Syndrome/Interstitial Cystitis criteria, 2 groups of patients were determined: BPS/IC and no BPS/IC. The association between BPS/IC and the wall signal intensity was compared. Results: In the 106 patients included, 82 had criteria for BPS/IC and 24 did not. A significant difference in the distribution of the signal was found between the 2 groups (p = 0.01). High signal intensity of the bladder wall was related to the presence of a BPS/IC with a sensitivity of 28% and a specificity of 88%. No signal intensity of the bladder wall was related to the absence of a BPS/IC with a sensitivity of 96% and a specificity of 29%. Conclusions: In -DWMRI, high bladder wall signal intensity helps to affirm a BPS/IC, whereas the absence of signal helps to exclude the diagnosis. Further studies are needed to confirm these preliminary results.

Keywords:
Bladder pain syndrome, Interstitial cystitis, Magnetic resonance imagery, Pelvic pain, Urinary bladder
1.
van de Merwe JP, Nordling J, Bouchelouche P, Bouchelouche K, Cervigni M, Daha LK, et al: Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol 2008; 53: 60–67.
2.
Homma Y, Ueda T, Tomoe H, Lin AT, Kuo HC, Lee MH, et al: Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015. Int J Urol 2016; 23: 542–549.
3.
Thoeny HC, Forstner R, De Keyzer F: Genitourinary applications of diffusion-weighted MR imaging in the pelvis. Radiology 2012; 263: 326–342.
4.
Towner RA, Wisniewski AB, Wu DH, Van Gordon SB, Smith N, North JC, et al: A feasibility study to determine whether clinical contrast enhanced magnetic resonance imaging can detect increased bladder permeability in patients with interstitial cystitis. J Urol 2016; 195: 631–638.
5.
Fujii S, Matsusue E, Kigawa J, Sato S, Kanasaki Y, Nakanishi J, et al: Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results. Eur Radiol 2008; 18: 384–389.
6.
Takeuchi M, Matsuzaki K, Nishitani H: Diffusion-weighted magnetic resonance imaging of endometrial cancer: differentiation from benign endometrial lesions and preoperative assessment of myometrial invasion. Acta Radiol Stockh Swed 1987 2009; 50: 947–953.
7.
Takeuchi M, Sasaki S, Ito M, Okada S, Takahashi S, Kawai T, et al: Urinary bladder cancer: diffusion-weighted MR imaging – accuracy for diagnosing T stage and estimating histologic grade. Radiology 2009; 251: 112–121.
8.
Yoshida S, Koga F, Kawakami S, Ishii C, Tanaka H, Numao N, et al: Initial experience of diffusion-weighted magnetic resonance imaging to assess therapeutic response to induction chemoradiotherapy against muscle-invasive bladder cancer. Urology 2010; 75: 387–391.
9.
Chung MK: Interstitial cystitis in persistent posthysterectomy chronic pelvic pain. JSLS 2004; 8: 329–333.
10.
Warren JW, Howard FM, Morozov VV: Is there a high incidence of hysterectomy and other nonbladder surgeries before and after onset of interstitial cystitis/bladder pain syndrome? Am J Obstet Gynecol 2013; 208: 77.e1–e6.
© 2018 S. Karger AG, Basel
2018
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.