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Endometrial Polyps

Sonohysterographic Evaluation

¹ All authors: Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157-1088.

View larger version (129K): [in a new window]   Fig. 1A. —Single polyp in 44-year-old woman who presented with excessive bleeding. Sagittal transvaginal sonogram shows endometrium (arrows) in fundus. Thickness of endometrium is 10 mm.

View larger version (146K): [in a new window]   Fig. 1B. —Single polyp in 44-year-old woman who presented with excessive bleeding. Sagittal sonohysterogram shows single round 1.9-cm echogenic polyp (arrow). Note otherwise thin endometrium (2 mm).

View larger version (160K): [in a new window]   Fig. 2A. —Multiple polyps in 41-year-old woman who presented with pain. Sagittal transvaginal sonogram shows 8-mm-thick endometrium (cursors).

View larger version (138K): [in a new window]   Fig. 2B. —Multiple polyps in 41-year-old woman who presented with pain. Sagittal sonohysterogram shows three small round echogenic polyps (two shown by arrows). Polyps are 5, 6, and 7 mm in diameter.

View larger version (178K): [in a new window]   Fig. 3A. —Polyp with cystic appearance in 71-year-old woman who presented with postmenopausal bleeding. Sagittal transvaginal sonogram shows 26-mm-thick endometrium with cystic appearance (arrow).

View larger version (141K): [in a new window]   Fig. 3B. —Polyp with cystic appearance in 71-year-old woman who presented with postmenopausal bleeding. Sagittal sonohysterogram shows large broad-based polyp with cysts (arrow) and 8-mm associated endometrial thickening (arrowheads) caused by hyperplasia.

View larger version (168K): [in a new window]   Fig. 4A. —Elongated polyp in 55-year-old woman who presented with postmenopausal bleeding. Sagittal transvaginal sonogram shows lobular 9- to 20-mm-thick endometrium (cursors and arrows).

View larger version (160K): [in a new window]   Fig. 4B. —Elongated polyp in 55-year-old woman who presented with postmenopausal bleeding. Sagittal sonohysterogram shows 2.3-cm elongated angular polyp (arrow) with 0.8-cm stalk and small 0.7-cm polyp (arrowhead).

View larger version (111K): [in a new window]   Fig. 5A. —Broad-based polyp in 68-year-old woman who presented with postmenopausal bleeding. Sagittal transvaginal sonogram shows 8-mm-thick endometrium (arrows).

View larger version (131K): [in a new window]   Fig. 5B. —Broad-based polyp in 68-year-old woman who presented with postmenopausal bleeding. Sagittal sonohysterogram shows 2-cm broad-based polyp (cursors).

View larger version (128K): [in a new window]   Fig. 6A. —Polyp and diffuse endometrial thickening in 44-year-old woman who presented with excessive bleeding. Sagittal transvaginal sonogram shows endometrium (cursors) with focal thickness of 10 mm.

View larger version (141K): [in a new window]   Fig. 6B. —Polyp and diffuse endometrial thickening in 44-year-old woman who presented with excessive bleeding. Sagittal sonohysterogram shows 11-mm polyp (arrow) and diffuse endometrial thickening (arrowheads) caused by hyperplasia.

View larger version (132K): [in a new window]   Fig. 7A. —Polypoid mass in 48-year-old woman who presented with excessive bleeding. Sagittal transvaginal sonogram shows endometrial thickening (cursors).

View larger version (126K): [in a new window]   Fig. 7B. —Polypoid mass in 48-year-old woman who presented with excessive bleeding. Sagittal sonohysterogram shows polypoid and diffuse thickening (arrowheads) caused by hyperplasia only.

View larger version (140K): [in a new window]   Fig. 8A. —Fibroid in 53-year-old woman who presented with postmenopausal bleeding. Sagittal transvaginal sonogram shows hypoechoic endometrial thickening (arrowheads).

View larger version (161K): [in a new window]   Fig. 8B. —Fibroid in 53-year-old woman who presented with postmenopausal bleeding. Sagittal sonohysterogram shows submucosal fibroid with thin overlying endometrium (cursors).

View larger version (132K): [in a new window]   Fig. 9A. —Adenomyoma in 43-year-old woman who presented with excessive bleeding. Sagittal transvaginal sonogram shows 2.9-cm-thick central uterine mass (cursors).

View larger version (125K): [in a new window]   Fig. 9B. —Adenomyoma in 43-year-old woman who presented with excessive bleeding. Sagittal sonohysterogram shows subendometrial mass (arrow) with pathologic diagnosis of adenomyoma.

View larger version (132K): [in a new window]   Fig. 10A. —Blood clot in 69-year-old woman who presented with postmenopausal bleeding. Sagittal transvaginal sonogram shows 8-mm-thick endometrium (cursors).

View larger version (135K): [in a new window]   Fig. 10B. —Blood clot in 69-year-old woman who presented with postmenopausal bleeding. Sagittal sonohysterogram shows polypoid mass (arrow). Pathologic diagnosis was blood clot. This may be difficult to differentiate from polyp if it cannot be flushed during procedure.

View larger version (126K): [in a new window]   Fig. 11. —Synechiae in 46-year-old woman who presented with excessive bleeding. Sagittal sonohysterogram shows echogenic strands (arrowhead) traversing endometrial canal consistent with synechiae. Note that anterior myometrial fibroid was also seen.

View larger version (133K): [in a new window]   Fig. 12A. —Endometrial adenocarcinoma in 37-year-old woman who presented with excessive bleeding. Sagittal transvaginal sonogram shows 21-mm-thick endometrium (cursors).

View larger version (176K): [in a new window]   Fig. 12B. —Endometrial adenocarcinoma in 37-year-old woman who presented with excessive bleeding. Sagittal sonohysterogram shows 4-cm polypoid mass (arrow). Pathologic diagnosis was endometrial adenocarcinoma. Difficulty in adequately distending endometrial canal despite use of occlusive balloon may have been sign of carcinoma.

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