Hyperechoic bands within the endometrial cavity on ultrasound are most diagnostic of which condition?

• A. Synechia
• B. Endometrial polyp
• C. Fibroid
• D. Endometritis

Answer: (A)

Intrauterine adhesions create fibrous bands that span across the endometrial cavity. On ultrasound these adhesions appear as hyperechoic (bright) linear bands extending within the cavity, sometimes bridging from wall to wall. This pattern is characteristic of synechiae (Asherman syndrome) and reflects scar tissue forming bands that partition the cavity.

A focal endometrial polyp would appear as a discrete intracavitary mass, often with a stalk and Doppler flow. A fibroid within the cavity is typically seen as a well-defined mass that may distort the cavity. Endometritis tends to cause a thickened, irregular endometrium with possible fluid or gas and increased vascularity, not linear intracavitary bands.