Endometrial T2 values and thickness measured during the spontaneous menstrual cycle: potential imaging biomarker related to female physiological hormones

Objectives The endometrium undergoes morphological and functional changes during menstrual cycles, regulated by female hormones. MRI T2 weighted imaging (T2WI) plays an essential role in endometrial disease evaluation. This study aims to define the cyclic course of endometrial T2 values and thickness and explore their relationship with basal female sex hormones.

We prospectively recruited 38 healthy volunteers (20–30 years:22; 30–40 years:16), 3.0 T MR were performed during the menstrual phase (MP), follicular phase (FP), peri-ovulation phase (OP), and luteal phase (LP). Basal serum oestradiol (E), progesterone (P), luteinizing hormone (LH) and follicle stimulating hormone (FSH) hormone was tested. Endometrium thicknesses, T2 values were obtained in each phase. Pearson correlation test, Fisher's least significant difference (LSD) test, the analysis of variance (ANOVA) test, and the paired sample t test were applied.

The endometrium thickness was significantly thinner in the younger age group (p < 0.001). The thickness was significantly thinner in first half compared with that in the second half in both groups (p < 0.001). Endometrial T2 values were significantly shorter in menstrual cycles compared with the other three phases (p ≤ 0.001). Both endometrial T2 value and thickness were correlated to female hormones. Basal FSH and P were correlated with T2 values in the menstrual phase in the 30–40 year group. Serum FSH was correlated with endometrial thickness.

T2 mapping and endometrium thickness distinguish in different cyclic phases, provided background information for evaluation pathologic conditions. Moreover, with their correlations with female basal sex hormones, we found the T2 mapping sequence can provide a potential biomarker for quantifying the endometrium's physiological status. Advances in knowledge The current study is the first to investigate the relationship between T2 values and basal sex hormones. This new technique may find a role in determining endometrium functions such as receptivity and might have potential clinical significance in the diagnosis of endometrium-related gynecology diseases. Similar content being viewed by others

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We thank Hui Liu for MRI parameters setting of this study; Hao Zhang for serum female hormone measurements; and Wei Han for the design of local SAS evaluation programs. Funding No competing financial interests exist. Funded by Basic Scientific Research Program of Chinese Academy of Medical Sciences (2019PT320008 and 2018PT32003). Author information Authors and Affiliations Corresponding authors Ethics declarations Conflict of interest The authors have nothing to declare. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Ding, N., He, Y., Qi, Y. et al. Endometrial T2 values and thickness measured during the spontaneous menstrual cycle: potential imaging biomarker related to female physiological hormones. Chin J Acad Radiol 4, 98–104 (2021). https://doi.org/10.1007/s42058-021-00063-5 Received: Revised: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s42058-021-00063-5