endometrial polyp

Ultrasound

The best time of examination for endometrial polyp is postmenstrual. 

• ​usually solitary homogeneous and echogenic lesion
• interrupted mucosa sign ¹⁰: the endometrial polyp focally interrupts the normal mucosal contour of the uterine cavity
• it is rarely hypoechoic or heterogeneous
• a stalk to the polyp may either be thin (i.e. pedunculated) or broad-based
• the bright edge sign ¹¹: the appearance of one or two well-defined short echogenic linear echoes at the polyp borders which are perpendicular to the ultrasound beam
• may appear isoechoic as a focal non-specific thickened endometrium, without visualization of a discrete mass
• can rarely appear as diffuse endometrial thickening as the endometrial polyp fills the endometrial cavity, mimicking endometrial hyperplasia
• rarely cystic spaces could be seen corresponding to dilated glands filled with proteinaceous fluid within the polyp ³
• may be surrounded by endometrial fluid

Color Doppler

• feeding artery sign: a single feeding vessel may be seen extending to the polyp on color Doppler imaging ⁷
  • visualization of a vascular pedicle is 76% sensitive and 95% specific for endometrial polyps ⁷

3D ultrasound

• 3D ultrasound may be useful to help delineate the borders of a polyphttps://youtu.be/J0gBGuyqeGc?si=7A1lrlJtibOAp9B0

Sonohysterography 

Although not always necessary for a diagnosis, polyps are well-characterized on sonohysterography and appear as echogenic, smooth, intracavitary masses outlined by the fluid. The typical appearance of an endometrial polyp at sonohysterography is a well-defined, homogeneous, polypoid lesion that is isoechoic to the endometrium with preservation of the endometrial-myometrial interface ⁵. There is usually a well-defined vascular pedicle within the stalk.