Abnormally thickened endometrium (differential)
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Abnormally thickened endometrium on imaging may occur for a number of reasons which may be categorised by whether or not they are related to pregnancy. Aetiologies may also classified by whether the patient is premenopausal or postmenopausal.
Pregnancy related
- early pregnancy, prior to sac being visualized (<5 weeks of gestation)
- ectopic pregnancy
- retained products of conception: heterogenously thickened endometrium, with increased vascularity
- intra-uterine blood clot: heterogenous endometrium with no vascularity
- molar pregnancy: thickened with multiple small cystic spaces
- recent gestational state (delivery)
Non-pregnancy related
- endometrial carcinoma: variable appearances
- endometrial hyperplasia: usually uniformly hyperechoic and tends to be diffuse
- endometrial polyp: usually hyperechoic, often focal, look for vascular stalk
- Tamoxifen related endometrial changes: variable appearances
- endometritis
- ovarian tumours associated with endometrial thickening
Practical points
Endometrial
-
endometrial thickness in the secretory phase (days 14-28) may normally be up to 12-16 mm (see: endometrial thickness)
.- nonemergent ultrasounds are optimally evaluated at day 5-10 of the menstrual cycle to reduce the wide variation in endometrial thickness
- the thickest portion of the endometrium should be measured
- if there is fluid in the uterine cavity, it should be excluded from the measurement, which would be the sum of the two sagittal plane thicknesses
- ~10% of endometrial carcinoma occurs in premenopausal women
See also
-</ul><h5>Practical points</h5><p>Endometrial thickness in the secretory phase (days 14-28) may normally be up to 12-16 mm (see: <a href="/articles/endometrial-thickness">endometrial thickness</a>).</p><h4>See also</h4><ul>- +</ul><h5>Practical points</h5><ul>
- +<li>endometrial thickness in the secretory phase (days 14-28) may normally be up to 12-16 mm (see: <a href="/articles/endometrial-thickness">endometrial thickness</a>)<ul><li>nonemergent ultrasounds are optimally evaluated at day 5-10 of the menstrual cycle to reduce the wide variation in endometrial thickness</li></ul>
- +</li>
- +<li>the thickest portion of the endometrium should be measured</li>
- +<li>if there is fluid in the uterine cavity, it should be excluded from the measurement, which would be the sum of the two sagittal plane thicknesses</li>
- +<li>~10% of endometrial carcinoma occurs in premenopausal women</li>
- +</ul><h4>See also</h4><ul>
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