Imaging assessment of endometrial thickness

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Posted by Master, Doctor Lam Thi Kim Chi - Doctor of Radiology - Department of Diagnostic Imaging - Vinmec Danang International General Hospital

Endometrial thickness is a parameter commonly measured on routine gynecological ultrasound and MRI. The shape and thickness of the endometrium depends on whether the patient is of reproductive age or postmenopausal and if they are of reproductive age, when in the menstrual cycle they are examined.

In fact, endometrial thickening is associated with endometrial cancer. So what is the normal endometrial thickness? Follow along with the article on imaging methods to evaluate endometrial thickening.

1. Ultrasound


Ultrasound was one of the first imaging techniques used to evaluate and monitor the endometrium. Usually, the medical staff will instruct the patient to drink plenty of water, hold urine, and inflate the bladder to get the best picture of the pelvic organs. After instructing and explaining the procedure, the doctor conducts survey and measurement of the endometrium on the longitudinal axis or Sagittal plane of the uterus. However, the indicators are ideally evaluated via transvaginal ultrasound.
Transvaginal ultrasound is the better imaging technique used to evaluate the endometrium as well as the uterus and bilateral appendages. The transducer of the ultrasound machine is inserted into the patient's vagina. Although this is a difficult technique, can cause discomfort for the patient, and cannot be performed in children, unmarried women (not sexually active), but transvaginal ultrasound can overcome this problem. Common disadvantages in transabdominal ultrasound such as thick abdominal wall, obesity, retroverted uterus, little urine in the bladder...

Siêu âm ngã âm đạo là kỹ thuật chẩn đoán hình ảnh
Siêu âm ngã âm đạo là kỹ thuật chẩn đoán hình ảnh

2. Pelvic Magnetic Resonance Imaging


Usually, magnetic resonance imaging is not the preferred diagnostic technique as soon as the patient's symptoms appear, but will be ordered after clinical examination, ultrasound or computed tomography but not provide adequate results for diagnosis and treatment. When a patient has an abdominal/vaginal ultrasound with abnormal thickening and suspicion of endometrium, but the cause has not been diagnosed, magnetic resonance is usually the next technique used, before making a decision. determine treatment and follow-up.
Magnetic resonance is very valuable in evaluating the endometrial condition, non-invasive, non-radioactive, performing and has quick results, can be performed in many subjects, including children and women unmarried. Therefore, magnetic resonance is gradually becoming popular and necessary in the diagnosis of pelvic diseases.

3. Normal endometrial thickness


Normal range of endometrial thickness depends on risk in endometrial cancer.
Non-menopausal stage: varies with menstrual cycle
Menstrual period (menstruation): 2-4mm Early proliferative phase (N6-N14): 5-7mm Late proliferative phase: <11mm post-ovulatory period: 7-16mm After curettage or spontaneous abortion: <5mm. If thicker, pay attention to the remaining fetal components in the uterine cavity. Note: Indicators are meant for reference because endometrial thickness may vary from person to person. At the same time, these indicators often decrease when using combined oral contraceptives for a long time.
Menopausal phase: normally, endometrial thickness <5mm
Vaginal bleeding (without Tamoxifen): The upper limit of normal is 5mm, the risk of cancer when the endometrium is normal is about 0.07 %. If the endometrium is more than 5mm thick, the risk of cancer is about 7%. No history of vaginal bleeding: allow 8-11mm. Endometrial cancer risk <11mm is about 0.002%, >11mm is about 7% Although endometrial thickening is nonspecific, it is also an important marker in many benign and malignant diseases of the uterus. uterus. Therefore, patients need to go to a reputable hospital to conduct ultrasound and gynecological magnetic resonance imaging when the body has abnormal signs.
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