Uterine arteriovenous malformation

Case contributed by Dr Ammar Haouimi

Presentation

Prolonged vaginal bleeding. History of recent termination with dilation and curettage.

Patient Data

Age: 35 years
Gender: Female
Ultrasound

The grey-scale sonography shows an intramyometrial heterogeneous hypoechoic area of the anterior corporal region, containing anechoic tubular structures. The color Doppler demonstrates markedly increased flow with aliasing within the tubular structures.

 

On MRI the anterior uterine wall as well as the endometrial cavity show a complex with intermediate to low signal on T1 and heterogeneous high signal on T2. It contains multiple serpiginous structures with flow-related signal voids that enhance intensely after IV contrast administration.

 

Case Discussion

This case demonstrates the Doppler ultrasound and MRI appearances of an acquired uterine arteriovenous malformation.

The diagnosis of a uterine arteriovenous malformation should be considered in a young patient with massive prolonged bleeding, especially if there is a history of dilation/curettage, Cesarean section or termination of pregnancy.

On imaging differential diagnoses should include:

The best treatment is the arterial embolization of the malformation.

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Case information

rID: 63338
Published: 19th Oct 2018
Last edited: 14th Aug 2019
System: Gynaecology
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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