The Interrupted Mucosa Sign ndometrial polyps are benign focal overgrowths of endometrial tissue, often with variable amounts of vascularity and stroma encased by epithelium. Although the etiology of polyp development is unclear, endometrial polyps are quite common, identified in 13% to 50% of women with dysfunctional uterine bleeding and 10% of asymptomatic patients undergoing routine sonographic imaging. 1 Standard treatment is hysteroscopic removal to alleviate bleeding symptoms and exclude malignancy. 2 Aya Kamaya, MD, Pauline Chang Yu, MD, Carla Ramas Lloyd, MD, Bertha H. Chen, MD, Terry S. Desser, MD, Katherine E. Maturen, MD Received November 24, 2015, from the Departments of Radiology (A.K., T.S.D.) and Obstetrics and Gynecology (B.H.C.) Results-The mean age of the patients was 44.99 (SD, 9.88) years, 79.1% of whom were premenopausal. Pathologic diagnosis confirmed polyps in 58 (70.73%). A single feeding vessel was visualized in 36 patients with polyps (62.07%), whereas the interrupted mucosa sign was visualized in 34 (58.62%). The presence of a feeding vessel, the interrupted mucosa sign, or both detected 48 (82.76%) of the polyps. In the multivariate analysis, only the interrupted mucosa sign was a statistically significant predictor of pathologic diagnosis of a polyp (P = .035), with an odds ratio of 3.83 (95% confidence interval, 1.10-13.29). Other sonographic findings were not independent predictors of a polyp: mass (P = .35), single feeding vessel (P = .31), endometrial thickness (P = .88), and endometrial echogenicity (P = .45). The sensitivity, specificity, and positive predictive value of the interrupted mucosa sign were 59%, 75%, and 85%, respectively.Conclusions-The interrupted mucosa sign is a promising sonographic sign for identification of endometrial polyps, with greater predictive power than previously described signs. It has the potential to improve the diagnostic performance of sonography, especially when used in combination with other described signs.
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