UTERINE ARTERIOVENOUS-MALFORMATIONS - GRAY-SCALE AND DOPPLER US FEATURES WITH MR-IMAGING CORRELATION

PURPOSE: To describe the gray-scale and color and duplex Doppler ultra sound (US) and the magnetic resonance (MR) imaging features of uterine arteriovenous malformations (AVMs). MATERIALS AND METHODS: Uterine AV Ms in 10 patients were retrospectively evaluated. All patients underwe nt gray-scale US and color and duplex Doppler US. Nine underwent angio graphy with therapeutic embolization; four, MR imaging. The resistance index (RI), pulsatility index (PI), and peak systolic velocities (PSV s) were evaluated. RESULTS: AT gray-scale US, uterine AVMs were nonspe cific and manifested as subtle myometrial inhomogeneity, tubular space s within the myometrium, intramural uterine mass, endometrial mass, or cervical mass or sometimes as prominent parametrial vessels. Color Do ppler features were consistent and included intense juxtaposed signals with aliasing and apparent flow reversals. Spectral Doppler US reveal ed low-resistance flow (RI, 0.25-0.55; PI, 0.3-0.6) and PSVs greater t han 96 cm/sec, which suggests arteriovenous shunting. MR imaging showe d a bulky uterus, a focal uterine mass, disruption of the junctional z ones, serpiginous flow-related signal voids, and prominent parametrial vessels. CONCLUSION: Gray-scale morphology and Doppler US features sh ould allow noninvasive diagnosis of uterine AVMs. Doppler and MR imagi ng features of uterine AVMs may overlap with other causes of arteriove nous shunting, including abnormal placentation and gestational trophob lastic disease (GTD). These can be differentiated with serum beta huma n chorionic gonadotropin test results (negative with AVM, positive wit h GTD).