Endometrium Literature Review

ARTICLE REVIEW - 1 Imaging the Endometrium: Disease and Normal Variants Student Name : Dr. Sadia Shaheen

Specialization : MD Radiodiagnosis / Fellowship of Royal College of Radiology training program

Batch : March 2016

Year of study : 1st Year

Hospital : Sagar Hospital, Bangalore SOURCE : RADIOLOGICAL SOCIETY OF NORTH AMERICA (RSNA) - http://pubs.rsna.org INTRODUCTION :

Throughout the period from menarche to the menopause, including the prepurbertal, post-menopausal and the antenatal phases, the endometrium undergoes many physiological and pathological changes. The appearance of the endometrium depends on multiple factors like the patient’s age, phase of the menstrual

Primary imaging modality is the Ultrasound. A correlation of the findings with the sonohysterography, hystersalpingography, CT and MRI are often implied in the radiologic work-up of an endometrial disease.

In this article, approach to the endometrial imaging along with the spectrum of normal and pathologic findings in pediatric, premenopausal, pregnant, postpartum, and postmenopausal patients has been reviewed. REVIEW OF LITERATURE / ARTICLE SUMMARY / ARTICLE STRUCTURE :

Since this article represents the study of the radiological features of the endometrium and its normal variants over a period of time and not exactly a fixed period, it is more of an information article which would be theoretically and practically useful during our practice. Hence, I have clubbed all the sub-headings and have presented this article review. PAEDIATRIC ENDOMETRIUM

NORMAL APPEARANCE

At birth, the uterus is smaller to the cervix and the cervix generally appears as a thin echogenic line. With the onset of menarche, the endometrium reaches the adult morphology and varies with the stage of the menstrual

It is best appreciated on endovaginal scans. In the proliferative phase (days 6–14), the endometrium becomes thicker (5–7 mm) and more echogenic. In late proliferative (periovulatory) phase, multilayered appearance with an echogenic basal layer and hypoechoic inner functional layer, separated by a thin echogenic median layer is seen and measures up to 11 mm which remains upto 48 hours after ovulation. During the secretory phase, the endometrium becomes even thicker (7–16 mm) and more echogenic and reaches a maximum thickness during midsecretory