Original Research

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

Junko Nakamura, Takeharu Yoshikawa, Eriko Maeda, Hiroyuki Akai, Hiroshi Ohtsu, Naoto Hayashi, Kuni Ohtomo
South African Journal of Radiology | Vol 18, No 1 | a603 | DOI: https://doi.org/10.4102/sajr.v18i1.603 | © 2014 Junko Nakamura, Takeharu Yoshikawa, Eriko Maeda, Hiroyuki Akai, Hiroshi Ohtsu, Naoto Hayashi, Kuni Ohtomo | This work is licensed under CC Attribution 4.0
Submitted: 05 March 2014 | Published: 11 December 2014

About the author(s)

Junko Nakamura, Department of Radiology, Graduate School of Medicine, The University of Tokyo, Japan
Takeharu Yoshikawa, Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Japan
Eriko Maeda, Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Japan
Hiroyuki Akai, Department of Radiology, Research Hospital The Institute of Medical Science, The University of Tokyo, Japan
Hiroshi Ohtsu, Department of Clinical Trial Data Management, The University of Tokyo Hospital, Japan
Naoto Hayashi, Department of Radiology, Research Hospital The Institute of Medical Science, The University of Tokyo, Japan
Kuni Ohtomo, Department of Radiology, Graduate School of Medicine, The University of Tokyo, Japan


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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.


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