Comparison of transvaginal sonographic appearance and endometrial histology

Transvaginal sonograms were performed randomly in 51 patients in order to study the changes that occur in the normal endometrium. A total of 68 sonograms were performed. The accuracy of sonographic estimates of the endometrium was evaluated in 51 patients who underwent endometrial biopsy. Sonographic patterns were classified into six types. In the menstrual phase, the endometrial pattern showed hyper-echogenicity and an irregular border, then the pattern became thin and linear. The pattern assumed a leaf shape with hypo-echogenicity in the mid proliferative phase and hyper-echogenicity in the late phase. The enhancement of endometrial hyper-echogenicity and the disappearance of the midline were observed in the early secretory phase. A hyperechoic lumpy pattern was seen by the next menstruation. In all of the individuals studied, sonography was able to depict changes in the endometrium which corresponded to various phases of its histology.