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Figure 4a.  Hyperechoic line related to an underlying endometrial polyp. (a) Transverse endovaginal US scan shows a hyperechoic line surrounding the central endometrial complex (arrowheads). There are also cystic spaces within the central endometrial complex (arrows). (b) Subsequently obtained longitudinal hysterosonogram shows an endometrial polyp (arrow) with a narrow attachment to the endometrium (arrowheads).