Evaluation of endometrial thickness in postmenopausal women by using 3.0-T MRI

Junko Nakamura,Naoto Hayashi,Eriko Maeda,Takeharu Yoshikawa,Hiroyuki Akai,Kuni Ohtomo,Hiroshi Ohtsu

doi:10.4102/sajr.v18i1.603

Junko Nakamura, Naoto Hayashi + Show 5 more

Open Access

https://doi.org/10.4102/sajr.v18i1.603

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Abstract

Background: The accepted threshold for normal endometrial thickness is 5 mm; lesions with endometrial thickness < 5 mm are considered benign, whilst those > 5 mm areconsidered malignant. However, endometrium ≥ 5 mm on transvaginal ultrasonography inpostmenopausal woman is considered as asymptomatic endometrial thickening. However, recent studies suggest that asymptomatic endometrial thickness of even 8 mm – 11 mm in postmenopausal women may be normal.Objectives: The present study investigated the normal endometrial thickness range in 297 asymptomatic postmenopausal women using 3.0-T magnetic resonance imaging (MRI) T2-weighted sagittal images measured retrospectively by a single radiologist.Method: The data were classified according to patient age and postmenopausal duration, and the medical records and follow-up MR images were reviewed to assess the clinical outcome.Results: The mean endometrial thickness was 2.4 ± 0.1 mm (range: 0.1–11.6). The endometriumin 21 of 297 subjects was ≥ 5 mm thick. Follow-up MR images were obtained in 17 of these 21 women, and their endometrial thickness was found to have decreased in all of them. To date,none of the subjects has been diagnosed with endometrial cancer.Conclusion: Although 5 mm is considered the conservative threshold of normal endometrial thickness on MRI of postmenopausal women, this figure should not, to avoid excessive false-positive diagnoses, be assumed as an indication of malignancy.

Highlights

Endometrial abnormalities pose diagnostic challenges for radiologists and gynaecologists
Current literature concerning transvaginal ultrasonography (TVUS) imaging suggests that asymptomatic endometrial thickness of 8 mm – 11 mm in a postmenopausal woman may be normal.[6,7,8,9,10]
Three (1.0%) of the 21 women had an endometrium > 10 mm. Two of these women were referred to the gynaecology department following Magnetic resonance imaging (MRI), and one was diagnosed with endometrial hyperplasia, while no malignancy was detected in the second woman

Summary

Introduction

Endometrial abnormalities pose diagnostic challenges for radiologists and gynaecologists. Menstrual status is potentially the most influential factor affecting endometrial thickness. The accepted normal value for endometrial thickness is < 5 mm,[1,2] endometrium ≥ 5 mm on transvaginal ultrasonography (TVUS) imaging in a postmenopausal woman is considered asymptomatic endometrial thickening.[3,4,5] Current literature concerning TVUS imaging suggests that asymptomatic endometrial thickness of 8 mm – 11 mm in a postmenopausal woman may be normal.[6,7,8,9,10]. Endometrium ≥ 5 mm on transvaginal ultrasonography in postmenopausal woman is considered as asymptomatic endometrial thickening. Recent studies suggest that asymptomatic endometrial thickness of even 8 mm – 11 mm in postmenopausal women may be normal

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Discussion

Conclusion