In this slide layers of uterus is explained in detail

1. Layers of Uterus
DESCRIPTON ON ULTRASOUND

2. Layers of Uterus
• Endometrium
• Myometrium
• perimetrium

4. Myometrium
Three layers of myometrium recognizable on US
• Inner hypoechoic zone, subendometrial halo
• Intermediate myometrial layer The intermediate layer is
located between the junctional zone centrally and the
arcuate blood vessels peripherally and is the thickest
component of the myometrium, largely accounting for the
shape of the uterus.
• Subserosal layer (variable echogenicity)

7. Stages of the Menstrual Cycle
Menstrual phase
• Endometrium degenerates due to falling estrogen
and progesterone.
 Proliferative phase
• Endometrium thickens due to increased estrogen.
 Secretory phase
• Endometrium continues to grow and secrete
substances needed for implantation, supported
by estrogen and progesterone secretion by
corpus luteum.

9.  Basal layer o Constant
 Functional layers (changes during cycle)
ULTRASOUND APPEARENCE
Outer hypoechoic layer
Inner echogenic layer o Spongiosum
Echogenic cavity line (sometimes with fluid)
 The sonographic appearance and thickness of the
endometrium vary with the menstrual cycle

12. • Endometrial thickness is
measured in AP
diameter on a midline
sagittal image,
perpendicular to the
long axis of the
endometrium

14. Endometrium
Menstrual
• Hypoechoic basalis
• Thin hyperechoic band
Endometrial cavity and residual functionalis

15. Proliferative Phase
progressively thickens to 8-12mm by day 14
 Outer hypoechoic line (Basal Layer)
 Hyperechoic line (Boundary of the functional
layer with basal layer)
 Slightly hypoechoic band (Proliferating
funcional Layer)
Central hyperechoic line (Canal)

16. Secretory
 further thickening, but echogenicity increases
to give single band appearance
 Thin hypoechoic line (basal layer)
 Thick hyperechoic band (functional layer)
 Thin hyperechoic line (cavity)

17. Phases of endometrium
thickness appearance
Days 0-5
(Menstrual Phase)
measuring up to
approximately 4 mm.
a discrete, thin, hyperechoic line
Days 7-9
(Early Proliferative
Phase)
measuring up to
approximately 8 mm
functional layer becomes
hypoechoic due to estrogen effect
Days 12-14
(Late Proliferative Phase)
measures up to
approximately 11 mm
oexhibits a multilayered appearance
composed of a thin, central
echogenic line
osurrounded by a hypoechoic
functional layer
o hyperechoic outer layer
Days 15-20
(Secretory Phase)
measuring up to 15 to
16 mm
thickening and increased
echogenicity of the functional layer
of the endometrium due to the effects
of progesterone.
 This results in a homogeneously
echogenic endometrium