Nagamani Peri MD, Abstract Co-Author: Nothing to Disclose

Deborah Levine MD, Presenter: Nothing to Disclose

While the association of chronic anovulation and endometrial hyperplasia in patients with polycystic ovarian syndrome (PCOS) is well recognized by gynecologists, it is less described in the radiology literature. At times, we have seen a thick, cystic appearing endometrium in association with PCOS, and have wondered about its significance. Our objective was to assess the endometrial appearance on ultrasound in patients with PCOS.

An IRB approved, retrospective medical record review of ultrasound studies from 1/1/2000-12/31/2005 with sonographic impression of polycystic ovaries was performed. 167 patients (age range 16-49 years), with clinical features of PCOS were found. The sonographic endometrial thickness and appearance and the biopsy reports, when available, were evaluated.

Homogeneous endometrium was noted in 158/167 patients (thickness 1-27 mm, mean 6.9 +/-3.4 mm). 8 of these 158 patients had endometrial biopsy, of which 2 were proliferative, 2 were secretory, 1 was hyperplasia and 3 were scant/ inactive endometrium. In the patient with hyperplasia, the endometrium was 27 mm thick. Heterogeneous endometrium was noted in 9/167 patients (thickness 4-21 mm; mean 14.2 +/- 5.8 mm). 6 of these also had tiny cysts (endometrial thickness 4-20 mm; mean 14.5 +/- 6.0 mm), one of whom had both cystic foci and a focal mass. 8 of the 9 patients with heterogeneous endometrium had biopsy, of which 7 had proliferative endometrium. The one with focal mass also had a polyp.

A thick, cystic appearing endometrium in patients with PCOS is most likely due to prolonged proliferative phase. Biopsy is needed to exclude hyperplasia.

A thick, cystic appearing endometrium in patients with PCOS is most likely due to prolonged proliferative phase. Biopsy is needed to exclude hyperplasia.

Peri, N, Levine, D, Sonographic Evaluation of Endometrium in Patients with Polycystic Ovarian Syndrome.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4435990.html