Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Hapugoda S, Babu V, et al. Endometrial reflectivity (ultrasound grading). Reference article, Radiopaedia.org (Accessed on 18 Apr 2024) https://doi.org/10.53347/rID-47996
Endometrial reflectivity grading on ultrasound is a system initially proposed by Smith et al. in 1984 which classifies the endometrium into four types according to the echotexture pattern. They are considered to be useful in deciding on receptivity in in-vitro fertilisation (IVF).
The Smith system is as follows:
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grade A: hyperechoic
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grade B: isoechoic
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grade C: triple line / trilaminar
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grade D: echogenic black region surrounding the midline echo
Further versions have been proposed subsequently which include a 3-grade system by Gonen and Casper in 1990.
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type a: entirely homogeneous, hyperechogenic pattern, without a central echogenic line
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type b: intermediate iso-echogenic pattern, with the same reflectivity as the surrounding myometrium and a non-prominent or absent central echogenic line
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type c: multilayered ‘triple-line’ endometrium consisting of a prominent outer and central hyperechogenic line and inner hypo-echogenic or black region
Or a two grade system by Sher et al. in 1991:
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non-multilayered homogeneous hyperechogenic or iso-echogenic endometrium compared with the myometrium
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multilayered triple-line multilayered pattern, ‘halo pattern’ = outer peripheral layer of denser echogenicity and a central sonolucent area.
See also
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1. Sterzik K, Grab D, Rosenbusch B et-al. Receptivity of the endometrium: comparison of ultrasound and histologic findings after hormonal stimulation. Geburtshilfe Frauenheilkd. 1991;51 (07): 554-8. doi:10.1055/s-2007-1026198 - Pubmed citation
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2. Zaidi J, Campbell S, Pittrof R et-al. Endometrial thickness, morphology, vascular penetration and velocimetry in predicting implantation in an in vitro fertilization program. Ultrasound Obstet Gynecol. 1995;6 (3): 191-8. doi:10.1046/j.1469-0705.1995.06030191.x - Pubmed citation
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3. Ohno Y, Fujimoto Y. Endometrial oestrogen and progesterone receptors and their relationship to sonographic appearance of the endometrium. Hum. Reprod. Update. 1999;4 (5): 560-4. Pubmed citation
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4. Friedler S, Schenker JG, Herman A et-al. The role of ultrasonography in the evaluation of endometrial receptivity following assisted reproductive treatments: a critical review. Hum. Reprod. Update. 1996;2 (4): 323-35. doi:10.1093/humupd/2.4.323 - Pubmed citation
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