Arteriovenous malformation of mesosalpinx associated with a 'vanishing' ectopic pregnancy: diagnosis with three-dimensional color power angiography

We describe two cases of pelvic arteriovenous malformation diagnosed with t he aid of three-dimensional color power angiography. In both cases, beta-hu man chorionic gonadotropin (beta-hCG) increased to significant levels (8413 and 1560 mIU/ml, respectively); however, neither an intrauterine nov an ad nexal gestational sac could be found. In each case, we observed an adnexal mass with several tortuous areas exhibiting abundant turbulent flow. The di agnosis of arteriovenous malformation was made and further assessment by th ree-dimensional color power angiography and magnetic resonance imaging (MRI ) was carried out. The complex vascular anatomy of arteriovenous malformati on, including its feeding vessels and drainage, was clearly depicted by thr ee-dimensional color power angiography and correlated well with magnetic re sonance angiography. Levels of beta-hCG decreased in subsequent tests, and eventually became negative 2-3 months later without any intervention. We be lieve that an involutional ectopic pregnancy induced the rapid growth of th e arteriovenous malformations within the mesosalpinx. Three-dimensional col or power angiography can be performed quickly and easily, using existing ul trasound equipment. It improves our understanding of complicated vasculatur e, and thus is a useful adjunct to two-dimensional and color Doppler ultras ound in the diagnosis of arteriovenous malformation.