48 The Endometrium

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GU 48-1 Normal premenopausal endometrium. A sagittal image of the uterus obtained during menstruation shows a thin endometrial lining (arrow) with a trace of fluid.72

• Fig GU 48-2 Normal premenopausal endometrium. Sagittal image of the uterus obtained during the late proliferative phase of the menstrual cycle demonstrates the endometrium with a multilayered appearance (arrows).72

• Fig GU 48-3 Normal premenopausal endometrium. Sagittal image of the uterus obtained during the secretory phase of the menstrual cycle shows a thickened, echogenic endometrium (cursors).72

• Fig GU 48-4 Intradecidual sign. Transvaginal image of a retroflexed uterus. Note the echogenic ring (arrow) eccentrically located in the endometrium that abuts the interface between the anterior and posterior endometrium. (Courtesy Deborah Levine, MD, Boston, MA.)

• Fig GU 48-5 Double decidual sac sign. Sonogram of an early intrauterine pregnancy demonstrates two hyperechoic rings (arrows). The inner ring represents the combined chorion-decidua capsularis, and the outer ring represents the decidua parietalis.72

Fig GU 48-6 Decidual cast. Transabdominal image reveals echogenic material within the endometrium (cursors).72

Fig GU 48-7 Blighted ovum. Sonogram shows the gestational sac with no visible embryo or yolk sac. A small subchorionic hematoma is noted (arrow).72

• Fig GU 48-8 Endometritis. Multiple echogenic foci within the endometrium (arrow) represent gas.72

• Fig GU 48-9 Retained products of conception. (A) Echogenic material within the endometrial canal (arrows). (B) Echogenic material with posterior acoustic shadowing (arrow) is consistent with calcified retained products of conception.72

• Fig GU 48-10 Postmenopausal endometrial atrophy. The endometrium has thin walls and is outlined with fluid.72

• Fig GU 48-11 Endometrial polyp. Sonohysterogram reveals a small polyp attached by a stalk to the endometrium (black arrow). An echogenic focus in the endometrial cavity (white arrow) represents injected air.72

• Fig GU 48-12 Submucosal fibroid. (A) Transvaginal sonogram shows a uterine mass (arrows) with posterior acoustic shadowing. (B) Sonohysterogram demonstrates the submucosal location of the mass, a finding that is consistent with an echogenic fibroid.72

Fig GU 48-13 Endometrial hyperplasia. There is diffuse thickening of the endometrium.72

• Fig GU 48-14 Endometrial adenocarcinoma. Heterogeneous endometrial mass (arrows) that is difficult to distinguish from the myometrium. Cursors indicate the entire transverse width of the uterus.72