Clinical implications of the echo enhancement artifact in volume sonography of the uterus

Objective. The purpose of this report is to present a 3-dimensional (3D) imaging artifact, the echo enhancement artifact, which may have important clinical implications in the display of the midcoronal plane of the uterus in volume sonography and to suggest a technologic modification to current 3D equipment that may help the user in the identification of such an artifact. Methods. Three coronal planes were retrieved out of a 3D volume of a uterus obtained during the luteal phase of the menstrual cycle by standard postprocessing techniques. The effect of the echo enhancement artifact on the display of the coronal planes was compared. Results. Coronal planes, obtained in the posterior myometrium, below the endometrial cavity, appeared to show what looked like endometria and could potentially be confused with the anatomic midcoronal plane of the uterus by an inexperienced operator because of the echo enhancement artifact. Conclusions. Physicians reviewing diagnostic images retrieved out of a sonographic volume should be aware of this artifact and should review the anatomic plane that corresponds to the retrieved image before a clinical diagnosis is rendered. A technologic modification to current 3D equipment is suggested.