Hauth E, Libera H, Kimmig R, Forsting M
Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinik Essen.
Rofo. 2006 Mar;178(3):316-23. doi: 10.1055/s-2005-858934.
The purpose of the study was to determine the value of MR imaging of the pelvis in the diagnostic work-up of the endometrium in breast cancer patients in tamoxifen therapy.
MR imaging of the pelvis was performed on 24 patients (mean: 62 years, range: 51 - 74 years) and 30 healthy women (mean: 65 years, range: 51 - 73 years). The volume of the uterus and cervix and the maximal thickness of the endometrium, junctional zone and myometrium of the uterus were determined and compared to the confidence interval of the parameters in healthy women. The Mann-Whitney U-test was used to identify differences in the volume of the uterus and cervix and in the thickness of the uterine wall layers in both groups.
A comparison of the volume of the uterus and cervix and the thickness of the uterine wall layers in the two groups yielded no significant differences. The volume of the uterus and cervix showed no statistical differences between the two groups. The maximal height of the endometrium in the patient group showed a mean of 0.6 cm (range: 0.1 - 2.2 cm), and a mean of 0.4 cm (range: 0.1 - 1.2 cm) in the group of healthy women. The differences were not statistically significant. In all healthy women the endometrium showed homogeneous signal intensity in the sagittal T2-weighted images. In 12 of the 24 breast cancer patients, the endometrium showed inhomogeneous signal intensity. In 9 of 12 patients with an inhomogeneous endometrium with a thickness equal to or greater than 0.6 cm, histopathology confirmed polyps. In 3 patients endometrium hyperplasia was found. In one patient histopathology revealed a polyp and an endometrium carcinoma in stage T1 a N0. The endometrium carcinoma was not able to be seen via MR imaging.
MR imaging might be helpful in the diagnosis of endometrium pathologies during tamoxifen therapy. Therefore, MR imaging of the pelvis could be used as a diagnostic tool in the follow-up diagnosis of the endometrium in breast cancer patients in tamoxifen therapy.
本研究的目的是确定盆腔磁共振成像(MR成像)在接受他莫昔芬治疗的乳腺癌患者子宫内膜诊断检查中的价值。
对24例患者(平均年龄62岁,范围51 - 74岁)和30名健康女性(平均年龄65岁,范围51 - 73岁)进行盆腔MR成像检查。测定子宫和宫颈的体积以及子宫内膜、子宫交界区和子宫肌层的最大厚度,并与健康女性参数的置信区间进行比较。采用曼-惠特尼U检验来确定两组子宫和宫颈体积以及子宫壁各层厚度的差异。
两组子宫和宫颈体积以及子宫壁各层厚度的比较未发现显著差异。两组子宫和宫颈体积无统计学差异。患者组子宫内膜最大高度平均为0.6厘米(范围0.1 - 2.2厘米),健康女性组平均为0.4厘米(范围0.1 - 1.2厘米)。差异无统计学意义。所有健康女性在矢状面T2加权图像中子宫内膜信号强度均匀。24例乳腺癌患者中有12例子宫内膜信号强度不均匀。在12例子宫内膜不均匀且厚度等于或大于0.6厘米的患者中,9例经组织病理学证实为息肉。3例患者发现子宫内膜增生。1例患者组织病理学显示为息肉和T1 a N0期子宫内膜癌。通过MR成像未能发现子宫内膜癌。
MR成像可能有助于他莫昔芬治疗期间子宫内膜病变的诊断。因此,盆腔MR成像可作为接受他莫昔芬治疗的乳腺癌患者子宫内膜随访诊断的一种诊断工具。