The endometrium is 1.4 cm thick with uneven echogenicity and punctate echogenicity, which should be a finding on ultrasound, indicating that the patient may have endometrial hyperplasia or endometritis. The endometrium varies in thickness at different times of the menstrual cycle and undergoes proliferation and shedding in response to cyclic changes in ovarian hormones. Normally, the endometrium echoes evenly and does not show abnormal echoes during an ultrasound. If the lining of the uterus is thickened and has uneven echogenicity with multiple echoes, it may be endometrial hyperplasia or endometritis. 1. Endometrial hyperplasia. If the lining of the uterus is continuously subjected to the action of estrogen without progesterone antagonism, it will lead to excessive proliferation of the lining of the uterus, and the ultrasound will find that the lining of the uterus is not uniformly echogenic, and there may be more than one anechoic. For example, women approaching menopause or patients with polycystic ovary syndrome may experience this condition. 2. Endometritis. If there is endometritis, due to the invasion of bacteria into the endometrium, it will stimulate the endometrium to proliferate, resulting in the appearance of endometrial thickening and uneven echogenicity. With endometritis, the patient will experience symptoms such as abdominal cramping, lumbar pain and increased discharge. It is recommended to consult the Obstetrics and Gynecology Department for uneven endometrial echogenicity, and the management will be decided after evaluation by a professional doctor.