Subinvolution of the placental site associated with focal retained products of conception and placenta accreta mimicking uterine arteriovenous malformation on CT and MRI: a lesson to be learned

Godoy, Laiz Laura de; Torres, Ulysses S.; D'Ippólito, Giuseppe

doi:10.1590/0100-3984.2016.0131

Cited by 7 publications

(5 citation statements)

References 7 publications

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“…On MRI, it appears as an eccentric, heterogeneous, hypervascularized or hypovascularized intracavitary mass-usually with a signal that is hyperintense on T1WI and hypointense or intermediate on T2WI-with obliteration of the junctional zone, myometrial thinning, and intracavitary blood. The differential diagnosis includes GTD and acquired uterine arteriovenous malformation ( 1 , 10 ) .…”

Section: Retained Products Of Conceptionmentioning

confidence: 99%

Placental magnetic resonance imaging: normal appearance, anatomical variations, and pathological findings

et al. 2021

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Placental magnetic resonance imaging (MRI) has been increasingly requested, especially for the evaluation of suspected cases of placental adhesive disorders, generally known as placenta accreta. Abdominal radiologists need to become familiar with normal placental anatomy, anatomical variations, the current terminology, and major placental diseases that, although rare, are important causes of maternal and fetal morbidity and mortality. The aim of this didactic pictorial essay is to illustrate various findings on placental MRI, as well as to emphasize the importance of communication between radiologists and obstetricians in the search for best practices in the management of the affected patients.

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Section: Retained Products Of Conceptionmentioning

confidence: 99%

Placental magnetic resonance imaging: normal appearance, anatomical variations, and pathological findings

et al. 2021

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“…Contrast-enhanced MRI scans could confirm the marked vascular dilatation of the uterine wall, helping us to suspect SPS before the hysterectomy. 23 24 Angiography is considered the gold standard in AVM and possibly SPS diagnosis. SPS symptomatology may increase under hormonal changes such as menstruation or pregnancy, which may raise further suspicion.…”

Section: Discussionmentioning

confidence: 99%

“…6 Pulsed wave Doppler sonography may confirm an increased PSV with a low-resistance waveform which, given that high flow sonographic findings are commonly a result of true arteriovenous vascular malformations (AVMs), that may be acquired (eg, iatrogenic trauma leading to scar tissue and AVM formation) or congenital (eg, developmental vascular defects leading to a bed of abnormal arterio-venous communications). [20][21][22][23][24][25] While SPS diagnosis is only solidified via histological analysis, a high degree of suspicion from the clinical history such as abnormal uterine bleeding or recurrent loss of pregnancy may prompt the clinician to request imaging. Contrast-enhanced MRI scans could confirm the marked vascular dilatation of the uterine wall, helping us to suspect SPS before the hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Subinvolution of the placental site as the cause of hysterectomy in young woman

et al. 2021

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Subinvolution of placental sites (SPSs) is a rare but severe cause of secondary postpartum haemorrhage (PPH). SPS is characterised by the abnormal persistence of large, dilated, superficially modified spiral arteries in the absence of retained products of conception. It is an important cause of morbidity and mortality of young women. In this study, we present a case of secondary PPH in a young woman after uncomplicated caesarean delivery who was deemed clinically unstable, and finally, underwent emergent total abdominal hysterectomy. We reviewed the literature with an emphasis on the pathophysiology of this situation. Treatment of patients with SPS includes conservative medical therapy, hysterectomy and fertility-sparing percutaneous embolotherapy.

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“…A number of recent studies conducted in Brazil have highlighted the importance of imaging methods in the evaluation of the female reproductive system (22)(23)(24)(25)(26)(27) . The use of microCT was pivotal to observing the vasculariza tion in detail.…”

Section: Discussionmentioning

confidence: 99%

Proportional vascularization along the fallopian tubes and ovarian fimbria: assessment by confocal microtomography

et al. 2020

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Abstract Objective: To evaluate and reconstruct three-dimensional images of vascularization along the fallopian tube (FT), as well as to determine its relationship with the ovary and ovarian fimbria, and to quantify the blood vessels along the FT according to its anatomical segments, using confocal microtomography (micro-CT). Materials and Methods: Nine specimens (six FTs and three FTs with ovaries) were fixed in a solution of 10% formalin for > 24 h at room temperature. Iodine staining was performed by soaking the specimens in 10% Lugol’s solution for 24 h. All specimens were evaluated using micro-CT. A morphometric analysis was performed on the reconstructed images to quantify the vascular distribution along the FT. Results: In the FTs evaluated, the density of blood vessels was significantly greater in the fimbrial segments than in the isthmic segments (p < 0.05). The ovarian fimbria was clearly identified, demonstrating the important relationship between these vessels and the FT fimbriae. Conclusion: We believe that the vascularization in the fimbriae is greater than and disproportional that in the other segments of FT, and that the ovarian fimbria plays an important role in the development of that difference.

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Subinvolution of the placental site associated with focal retained products of conception and placenta accreta mimicking uterine arteriovenous malformation on CT and MRI: a lesson to be learned

Cited by 7 publications

References 7 publications

Placental magnetic resonance imaging: normal appearance, anatomical variations, and pathological findings

Placental magnetic resonance imaging: normal appearance, anatomical variations, and pathological findings

Subinvolution of the placental site as the cause of hysterectomy in young woman

Proportional vascularization along the fallopian tubes and ovarian fimbria: assessment by confocal microtomography

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