title: Efficacy of contrast-enhanced CT in assessing the endometrium.
abstract: OBJECTIVE
  The purpose of our study was to determine the efficacy of contrast-enhanced CT in detecting a thickened endometrium. We used transvaginal sonography as the reference standard.
  
  
  METHODS
  Between March 2005 and January 2007, data from 259 patients (mean age, 47 years; age range, 18-90 years) who underwent transvaginal sonography and contrast-enhanced CT of the pelvis were analyzed retrospectively. The endometrium was quantitatively measured in millimeters on sonography. On CT it was qualitatively categorized as normal, thickened, indeterminate, or not visualized and compared with the sonography findings and original radiology reports. When the endometrium was indeterminate (thickened or triangular in shape on axial images), sagittal reconstructions were performed for final categorization. Two reviewers evaluated the CT scans and sonograms jointly with differences resolved by consensus. Kappa, Wilcoxon's rank sum test, and intraclass correlation statistics were derived.
  
  
  RESULTS
  The overall sensitivity and specificity of CT in detecting the thickened endometrium was 53.1% and 93.5%, respectively, relative to transvaginal sonography. The positive and negative predictive values were 66.7% and 89.1%, respectively. Kappa, the statistical measure of agreement between CT and sonography data, was 0.5049. All cases of a triangular endometrium were normal in size on sagittal reconstruction images.
  
  
  CONCLUSIONS
  Routine pelvic CT correctly identifies a normal endometrium in most patients. Sagittal reconstruction images are helpful to further evaluate the endometrium on CT in cases with a prominent or triangular endometrium because these are often related to uterine version. CT is relatively insensitive in detecting the thickened endometrium but better able to identify gross rather than subtle thickening, which must be further characterized by transvaginal sonography.
authors: Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 E 210th St., Bronx, NY 10467, USA.
authors: Julia
authors: J
authors: Grossman
authors: Zina J
authors: ZJ
authors: Ricci
authors: Alla
authors: A
authors: Rozenblit
authors: Kathy
authors: K
authors: Freeman
authors: Fernanda
authors: F
authors: Mazzariol
authors: Marjorie W
authors: MW
authors: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004717:Endometrium / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives*; D008875:Middle Aged; D017698:Postmenopause; D017697:Premenopause; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014591:Uterine Diseases / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide