Ultrasound appearance of a pelvic arteriovenous malformation

Abstract

The diagnosis of pelvic arteriovenous malformations (AVM) is suggested by careful clinical examination. A history of previous trauma, including surgery, is helpful in establishing the etiology. Angiography results in definitive diagnosis in these patients. This case will indicate the role of ultrasound in helping to establish the diagnosis and follow the progress of pelvic AVM. CASE REPORTA 44-year-old woman presented in 1975 with dyspnea on exertion, lower abdominal pain, and fatigue. No history of pelvic trauma or surgery was elicited. The diagnosis of pelvic AVM was considered. A femoral arteriogram showed bilatera1 multiple arteriovenous communications in the pelvic vasculature. She underwent a total abdominal hysterectomy, bilateral hypogastric artery ligations, and division of all branches of the hypogastric artery in an attempt to control the lesion.She was admitted to Emory University Hospital in December 1976 because of partial obstruction of the vesical neck. A gynecologic examination showed large pulsatile masses a t both the right and left vaginal walls.An intravenous pyelogram and cystogram revealed slightly irregular bladder margins with increased soft-tissue densities in the pelvis surrounding the filled bladder.An ultrasound examination performed on the same day showed multiple serpiginous sonolucent structures within the pelvis, with slight bladder compression. &nographical]y these structures have a consistent with vessels (Figs. lA, 1B).

Malformação arteriovenosa uterina após doença trofoblástica gestacional

“…Atualmente, o procedimento, invasivo, divide espaço com propedêutica moderna, não invasiva, representada pela US. Os achados ultrasonográficos revelavam áreas hipoecóicas na intimidade miometrial, semelhando mola invasora 20 . Atualmente a US é associada à dopplervelocimetria colorida 21 , cujo espectro de onda, IR, IP e VSM, fornece indícios muito satisfatórios para o diagnóstico de MAVU.…”

Diagnóstico de malformação arteriovenosa uterina por meio da ultra-sonografia com doppler colorido e achados à angiorressonância magnética: relato de caso

“…A angiografia, atualmente, é reservada para os casos de intervenção cirúrgica ou embolização terapêu-tica (15,17) . As características ultra-sonográ-ficas são inespecíficas e incluem presença de estruturas tubulares, serpiginosas ou císticas, hipoecogênicas no miométrio (21) . O exame ultra-sonográfico com o Doppler colorido é mais específico no diagnóstico da MAV, notando-se vasos calibrosos com fluxo reverso.…”

Uterine Arteriovenous Malformation: Ultrasonographic, Magnetic Resonance and Radiological Findings

“…Torres et al [11] first used gray-scale US to describe this anomaly as multiple anechoic structures with a serpentine contour within the myometrium. US seemed to be a good screening test; however, these gray-scale morphologic features of AVMs in the uterus are often confusing and nonspecific [5,11,12]. With the development of color Doppler US, the diagnosis of uterine AVM can easily and convincingly be made [6,8,[13][14][15].…”