EP31.02: A new ultrasonographic three‐dimensional sign of presence of adenomyosis: the roots sign

to investigate the prevalence of a new three-dimensional (3D) ultrasound marker of presence of adenomyosis, the roots sign. We evaluated the prevalence roots sign in a series of 48 volumes suspected for the presence of direct and indirect ultrasonographic features of adenomyosis. Myometrial cysts, hyperechogenic islands and echogenic subendometrial lines and buds were direct features of adenomyosis while globular uterus, asymmetrical myometrial thickening, fan-shaped shadowing, irregular junctional zone was classified as indirect features of adenomyosis. The presence of this new 3D sign was identified when some stripes starting from the middle of the anterior or posterior uterine wall were present in the coronal plane (figure 1). The term “roots” were used because this appearance was similar to “roots of a tree.” The prevalence of this sign in this series of 48 volumes with direct or indirect previously described signs of adenomyosis was 50%. The other signs showed a prevalence of 85% of myometrial cysts, of 73% of hyperechogenic islands and of 75% of echogenic subendometrial lines and buds, respectively. Regarding globular uterus, asymmetrical myometrial thickening, fan-shaped shadowing and irregular junctional zone a prevalence of 48%, 60%, 35% and 79% were respectively present. The roots sign showed a particular association with presence of cysts (92%) and less with fan-shaped shadowing (37%). This is the first description of a new 3D ultrasonographic finding only visible evaluating the uterine coronal plane that showed a quite high prevalence also if compared with other direct and indirect findings. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.