Ultrasound of the endometrium: facts, controversies, and future trends

The role of ultrasound in the evaluation of the endome-trium has been overshadowed by a large volume of lit-erature about the ovaries and myometrium. In fact, aside from some investigations centering on the thickness of the endometrium in the normal woman and its relation-ship to the possibility of endometrial cancer, there has been little interest in the endometrium until very recently. Transvaginal sonography (TVS) has provided a modest improvement over transabdominal sonography (TAS) to image the endometrium and evaluate pathology; how-ever, the gynecologic community relies heavily on en-dometrial biopsy (EMB), dilatation and curettage (D&C), and hysteroscopy for endometrial diagnosis. The introduction of saline-infused hysterosonogra-phy (HSG) has revolutionized gynecologic ultrasound o