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False-Normal Appearance of the Endometrium on Conventional Transvaginal Sonography

Comparison with Saline Hysterosonography

Sherelle Laifer-Narin1, Nagesh Ragavendra1, Evelyn K. Parmenter1 and Edward G. Grant1,2

1 Department of Radiological Health Sciences, UCLA School of Medicine, 10833 LeConte Ave., Los Angeles, CA 90095.
2 Present address: Department of Radiology, West Los Angeles Veterans Administration Medical Center, 11301 Wilshire Blvd., Los Angeles, CA 90073.



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  		Fig. 1A. —Endometrial polyp in 55-year-old woman on hormone replacement therapy. Sagittal sonogram of uterus shows normal full wall endometrial thickness (cursors) of 5 mm.

 


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  		Fig. 1B. —Endometrial polyp in 55-year-old woman on hormone replacement therapy. Sonogram obtained after saline infusion shows homogenous echogenic mass (arrows) in endometrial canal.

 


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  		Fig. 2A. —Endometrial polyp in 34-year-old woman. Sagittal sonogram of uterus shows normal-appearing endometrium (straight arrows) measuring 8 mm and posterior uterine leiomyoma (curved arrows).

 


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  		Fig. 2B. —Endometrial polyp in 34-year-old woman. Sonogram obtained after saline infusion shows homogeneous echogenic mass (arrows) in endometrial cavity, and no submucosal involvement by posterior uterine leiomyoma is present.

 


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  		Fig. 3A. —Endometrial polyp in 36-year-old woman with retroverted uterus. Sagittal sonogram of uterus shows distal endometrium (cursors) to be normal in appearance measuring 4.5 mm. Note large intramural fibroid (arrows) with possibility of submucosal extension.

 


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  		Fig. 3B. —Endometrial polyp in 36-year-old woman with retroverted uterus. Sagittal sonogram of retroverted uterus after saline infusion shows homogeneous echogenic mass (arrows) in fundal portion of uterine cavity.

 


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  		Fig. 3C. —Endometrial polyp in 36-year-old woman with retroverted uterus. Sagittal sonogram obtained after withdrawal of hysterosonogram catheter shows no submucosal involvement by large intramural leiomyoma.

 


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  		Fig. 4A. —Endometrial polyp and submucosal leiomyoma in 43-year-old woman. Sagittal sonogram of uterus shows normal-appearing endometrium (cursors) measuring 4.4 mm and slight heterogeneity of posterior myometrium.

 


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  		Fig. 4B. —Endometrial polyp and submucosal leiomyoma in 43-year-old woman. Sagittal sonogram obtained after saline infusion shows small round echogenic mass (arrows) identified in endometrial cavity, consistent with polyp.

 


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  		Fig. 4C. —Endometrial polyp and submucosal leiomyoma in 43-year-old woman. Sagittal sonogram also shows submucosal leiomyomas (arrows) involving posterior endometrial wall and fundal uterine cavity.

 

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