Myometrial wall thickness ratio-A nomogram reference for diagnosing myometrial wall asymmetry
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This study established a nomogram for the anterior/posterior myometrial wall thickness ratio in women without uterine anomalies, finding a mean ratio of 0.99 with normal centile ranges from 0.64 to 1.45.
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Abstract
OBJECTIVE: Defining the normal range for the anterior/posterior myometrial wall thickness ratio in a cohort of women without adenomyosis or any other uterine wall anomaly on ultrasound examination.
METHODS: Anterior and posterior miometrial wall thickness was measured in 555 women (mean age 34.6 years old, range: 20-50 years) without any ultrasound findings of adenomiosis or other uterine pathology. Measurements were performed in the longitudinal plane of a stored 3D volume. Two observers made all measurements. The myometrial wall thickness ratio was estimated and distribution by centiles obtained. Correlation of myometrial thickness ratio with patient's age and parity was also estimated, using the Pearson's correlation coefficient. Intra- and inter-observer reproducibility were estimated using the intra-class correlation coefficient (ICC).
RESULTS: The mean ratio of the myometrial walls thickness (understood as anterior thickness/posterior thickness ratio) was 0.99 (95% CI: 0.96-1.01). The distribution of the ratio by centiles were as follows: 5%: 0.64, 10%: 0.70, 25%: 0.82, 50%: 0.96, 75%: 1.12, 90%: 1.30 and 95%: 1.45). The myometrial wall thickness ratio was not related to patient's age (Pearson's coefficient: 0.039, p = 0.371), neither to patient's parity (Pearson's coefficient: 0.004, p = 0.923). The ICC was 0.94 and 0.88 for observers 1 and 2, respectively. Inter-observer reproducibility was high (ICC: 0.83).
CONCLUSIONS: Myometrial thickness ratio in women with normal uterus at ultrasound examination is about 1. However, centile distribution shows that values as low as 0.64 or as high as 1.45 could be considered as normal.
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References (10)
- Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics via openalex
- Importance of transient myometrial contractions in diagnosis of adenomyosis and congenital uterine anomalies via openalex
- Interobserver Agreement in the Study of 2D and 3D Sonographic Criteria for Adenomyosis via openalex
- Inter-rater agreement in the diagnosis of adenomyosis by 2- and 3-dimensional transvaginal ultrasonography via openalex
- Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis via openalex
- Pathogenesis of uterine adenomyosis: invagination or metaplasia? via openalex
- Prevalence and risk factors of adenomyosis at hysterectomy via openalex
- Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group via openalex
- Transvaginal Ultrasound for the Diagnosis of Adenomyosis: Systematic Review and Meta-Analysis via openalex
- doi:10.1016/j.jmig.2019.11.001 via openalex
Source provenance
- europepmc
- last seen: 2026-10-20T06:13:28.455750+00:00
- openalex
- last seen: 2026-05-10T11:22:05.459129+00:00
- pubmed
- last seen: 2026-10-08T21:34:14.286141+00:00
- unpaywall
- last seen: 2026-10-20T06:27:24.728081+00:00
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