MR imaging appearance of the uterus in postmenopausal women receiving tamoxifen therapy for breast cancer: histopathologic correlation.
OBJECTIVE
To describe the spin-echo and dynamic gadolinium-enhanced magnetic resonance (MR) imaging appearance of the uterus in women receiving tamoxifen.


METHODS
Thirty-five postmenopausal women with breast carcinoma receiving tamoxifen therapy underwent pelvic MR imaging. T1-weighted, T2-weighted, and dynamic gradient-echo T1-weighted sequences were used. Twenty-seven patients underwent uterine sampling within 3 months of MR imaging.


RESULTS
Endometrial width on T2-weighted images ranged from 0.1 to 7.5 cm (mean thickness, 1.1 cm). Two uterine imaging patterns were noted. Patients with pattern 1 findings had homogeneous high signal intensity of the endometrium on T2-weighted images (mean, 0.5 cm) and enhancement of the endometrial-myometrial interface and a signal void in the lumen on gadolinium-enhanced images (18 patients). Patients with pattern 2 findings had heterogeneous endometrial signal intensity on T2-weighted images (mean, 1.8 cm) with enhancement of the endometrial-myometrial interface and latticelike enhancement traversing the endometrial canal on gadolinium-enhanced images (17 patients). Other imaging findings included subendometrial cysts, nabothian cysts, leiomyoma, and adenomyosis. Ten patients with pattern 1 findings had atrophic or proliferative endometria at histopathologic analysis; 12 of the 17 patients with pattern 2 findings had polyps, one of which had a focus of endometrial carcinoma.


CONCLUSIONS
MR imaging of the uterus showed two distinct patterns in women receiving tamoxifen therapy.
Ascher
S M
SM
Department of Radiology, Georgetown University Medical Center, Washington, DC 20007, USA.
Johnson
J C
JC
Barnes
W A
WA
Bae
C J
CJ
Patt
R H
RH
Zeman
R K
RK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D004717:Endometrium / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017698:Postmenopause; D013629:Tamoxifen / Q000009:adverse effects / Q000627:therapeutic use*; D014599:Uterus / Q000187:drug effects / Q000473:pathology*
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen