[Value of MRI in symptomatic patients treated with tamoxifen].
OBJECTIVE
To assess the MR imaging (MRI) findings in symptomatic tamoxifen treated-women with abnormal transvaginal sonography.


METHODS
From january 1997 to june 2000, 32 consecutive symptomatic tamoxifen treated-women with abnormal transvaginal sonography were prospectively studied by MRI. T1-weighted, T2-weighted, post-contrast T1-weighted and dynamic gradient-echo T1-weighted sequences were used. All patients underwent uterine sampling within one month of MRI.


RESULTS
Endometrial thickness at sonography ranged from 5 to 48 mm (mean thickness 19 mm), and on T2-weighted imaging ranged from 3 to 50 mm (mean=25 mm). Three MRI patterns were found. Pattern 1 (13 patients) was defined as homogeneous high signal intensity of the endometrium on T2W images, and signal void in the lumen on gadolinium-enhanced images. Pattern 2 (8 patients) was defined as heterogeneous endometrial signal on T2W images, and latticelike enhancement traversing the endometrial canal on gadolinium-enhanced images. Pattern 3 (11 patients) was defined as heterogeneous signal on T2W images with masses or nodules which were better seen on dynamic gadolinium-enhanced images. In pattern 1 we found 13 atrophic endometrium, in addition there were 4 polypoid glandulo-cystic proliferation (PGCP), and 1 adenomyosis. In pattern 2 we found 3 PGCP, 4 atrophy and 1 polyp without hyperplasia. The 2 carcinomas and the polyps with hyperplasia were found in pattern 3 (11 patients).


CONCLUSIONS
In our experience MRI allows differentiation of lesions which may require surgery from other lesions in which noninvasive follow-up is possible.
Taïeb
S
S
Département de Radiologie, Centre Oscar Lambret, Lille. s-taieb@o-lambert.fr
Ceugnart
L
L
Chevalier
A
A
Cabaret
V
V
Leblanc
E
E
Fournier
C
C
Besson
P
P
D000368:Aged; D000465:Algorithms; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D001284:Atrophy; D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy*; D003287:Contrast Media; D003663:Decision Trees; D004714:Endometrial Hyperplasia / Q000139:chemically induced* / Q000175:diagnosis* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000139:chemically induced* / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D011127:Polyps / Q000139:chemically induced* / Q000175:diagnosis* / Q000601:surgery; D011446:Prospective Studies; D013629:Tamoxifen / Q000009:adverse effects*
D000972:Antineoplastic Agents, Phytogenic; D003287:Contrast Media; D009942:Organometallic Compounds; D013629:Tamoxifen; D008536:Meglumine; C072417:gadoterate meglumine