What is the early transvaginal ultrasound (B-mode ultrasound) appearance of endometrial cancer?

　　The B-ultrasound manifestations of early endometrial cancer objectively reflect abnormal endometrial proliferation through imaging. In general, B-ultrasound may show endometrial thickening, uneven endometrial echogenicity, disordered uterine cavity line, abnormal blood flow signals, and signs of myometrial infiltration in early endometrial cancer. Patients are advised to seek timely medical consultation and undergo further examinations under a physician's guidance to confirm the diagnosis. Detailed analysis is as follows:

　　1. Endometrial Thickening

　　Abnormal proliferation of cancer cells causes disorderly hyperplasia of endometrial glands and stroma, exceeding normal physiological thickness. This is a common imaging feature in early stages. In postmenopausal women, endometrial thickness exceeds 5 mm, while in premenopausal women, it exceeds 12 mm, showing persistent thickening unrelated to the menstrual cycle.

　　2. Uneven Endometrial Echogenicity

　　Disordered glandular architecture within the cancerous lesion, atypical cellular hyperplasia, and secondary changes such as hemorrhage and necrosis lead to inconsistent ultrasound reflection signals. Locally increased, decreased, or mixed echogenic areas appear in the endometrium, with unclear boundaries and uneven echogenic intensity compared to surrounding normal endometrial tissue.

　　3. Disordered Uterine Cavity Line

　　The growth of cancerous tissue into the uterine cavity disrupts the normal anatomical structure of the endometrium, altering the uterine cavity morphology. Normally, the uterine cavity line appears as a clear, smooth hyperechoic band; early cancerous lesions may cause distortion, interruption, or disappearance of this line, with irregular protrusions appearing locally.

　　4. Abnormal Blood Flow Signals

　　Cause: Cancer cells stimulate neovascularization, and the vascular distribution is chaotic without smooth muscle tissue, resulting in reduced blood flow resistance. Ultrasound reveals increased and disordered blood flow signals.

　　5. Signs of Myometrial Infiltration

　　Cancer cells penetrate beyond the endometrial basal layer and infiltrate superficially into the uterine myometrium but have not yet involved deeper tissues. This is a key indicator for assessing infiltration in early stages. The boundary between the endometrium and myometrium becomes indistinct, with superficial hypoechoic areas visible in the local myometrium. The infiltration depth is less than half of the myometrial layer.

　　B-ultrasound examination is an important method for early screening of endometrial cancer; however, a definitive diagnosis requires hysteroscopic biopsy and histopathological evaluation. If abnormal uterine bleeding, vaginal discharge, or other symptoms occur, timely transvaginal ultrasound is recommended, with MRI or CT used as necessary for further assessment.