Towards endometriosis diagnosis by gadofosveset-trisodium enhanced magnetic resonance imaging.

Endometriosis is defined as the presence of endometrial tissue outside the uterus. It affects 10-15% of women during reproductive age and has a big personal and social impact due to chronic pelvic pain, subfertility, loss of work-hours and medical costs. Such conditions are exacerbated by the fact that the correct diagnosis is made as late as 8-11 years after symptom presentation. This is due to the lack of a reliable non-invasive diagnostic test and the fact that the reference diagnostic standard is laparoscopy (invasive, expensive and not without risks). High-molecular weight gadofosveset-trisodium is used as contrast agent in Magnetic Resonance Imaging (MRI). Since it extravasates from hyperpermeable vessels more easily than from mature blood vessels, this contrast agent detects angiogenesis efficiently. Endometriosis has high angiogenic activity. Therefore, we have tested the possibility to detect endometriosis non-invasively using Dynamic Contrast-Enhanced MRI (DCE-MRI) and gadofosveset-trisodium as a contrast agent in a mouse model. Endometriotic lesions were surgically induced in nine mice by autologous transplantation. Three weeks after lesion induction, mice were scanned by DCE-MRI. Dynamic image analysis showed that the rates of uptake (inwash), persistence and outwash of the contrast agent were different between endometriosis and control tissues (large blood vessels and back muscle). Due to the extensive angiogenesis in induced lesions, the contrast agent persisted longer in endometriotic than control tissues, thus enhancing the MRI signal intensity. DCE-MRI was repeated five weeks after lesion induction, and contrast enhancement was similar to that observed three weeks after endometriosis induction. The endothelial-cell marker CD31 and the pericyte marker α-smooth-muscle-actin (mature vessels) were detected with immunohistochemistry and confirmed that endometriotic lesions had significantly higher prevalence of new vessels (CD31 only positive) than the uterus and control tissues. The diagnostic value of gadofosveset-trisodium to detect endometriosis should be tested in human settings.

Acute seizure-suppressing effect of vagus nerve stimulation in the amygdala kindled rat.

PURPOSE: Vagus nerve stimulation (VNS) is a moderately effective anti-epileptic treatment. Clinically relevant animal models that are suitable to study the mechanism of action of VNS are not available. The aim of the current study was to develop a clinically relevant animal model for VNS-treated epilepsy that can be used to study the mechanism of action of VNS. METHODS: The anticonvulsive effect of VNS was studied in fully kindled rats by measuring behavioral and electrophysiological parameters. Afferent vagus nerve activation was confirmed by quantifying nNOS immunoreactive cells in the nucleus of the solitary tract (NTS). RESULTS: VNS rats had more nNOS immunoreactive cells/mm(2) in the NTS than shams. VNS induced a >25% decrease in stage 5 duration (S5D) in 32% of rats. Prior to VNS this type of responders suffered from seizures with a longer total seizure duration (TSD) than non-responders. In 21% of rats VNS resulted in a >25% decrease in TSD. This type of responders had a shorter TSD prior to VNS than non-responders. In 29% of rats VNS resulted in >200% increase in stage 5 latency (S5L). This type of responders had higher kindling rates than non-responders. CONCLUSION: The VNS-treated kindled rat is a clinically relevant animal model because it is a chronic epilepsy model that responds to VNS with effects that are comparable to the effects of VNS in epilepsy patients. In addition, this study demonstrates that VNS-treated kindled rats can be used to study the mode of action of VNS using immunohistochemical techniques.