Tree sign in adenomyosis by 5D ultrasound

Tree 🌳 sign for diagnosis of adenomyosis

The diagnosis of adenomyosis can be improved by using 3D ultrasound, as it allows for offline analysis with reconstruction of various anatomical lanes, especially the coronal plane of the uterus.
اهم حاجه تجيب الcoronal بال 3D

This particular view allows for subjective and objective assessment of the endo-myometrial JZ.
A thickened JZ (≥8 mm) with lack of defined boundaries and bridging of the JZ by echogenic endometrial foci are typical characteristics of adenomyosis on a 3D ultrasound multiplanar view or reconstruction

In 2019 Lopez et al proposed a novel sonographic marker for diagnosis of adenomyosis using HDlive technology introduced by GE (High Definition Live) with equivalent in mindray i live technology.

The volume for analysis is obtained in a similar fashion as for any 3D volume and the image is manipulated to create a coronal view of the uterus

Once the coronal plane is constructed, the ‘Edit Light’ functionality is activated,
يعني هتحرك ال source بتاع ال light
which allows directed trans-illumination of the object from different angles.

In cases of adenomyosis, the authors observed the ‘tree sign’, with the cervical canal and the lower endometrial cavity simulating the trunk and the irregularities of the JZ with perpendicular blood vessels, and hypoechoic lagoons completing the image of the tree.