CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSISEISENBERG

1. 48The Endometrium

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • 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

4. • 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

5. • 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

6. • 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.)

7. • 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

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

9. 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

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

11. • 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

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

13. • 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

14. • 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

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

16. • 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