Uterine arteriovenous malformations: the role of intravenous "dual-phase" CT angiography

The authors describe the use of dual-phase intravenous CT angiography of th e pelvis in two female patients, who presented with ongoing excessive vagin al bleeding, to demonstrate large adnexal and uterine arteriovenous malform ations (AVMs). Power Doppler was used as the initial modality to diagnose t he AVMs. CT angiography, along with 3-D rendering in the form of maximum in tensity projections and shaded surface display, were especially useful for anatomical conceptualization to the gynecologist. This greatly helped in th e subsequent management in the form of therapeutic embolization in both pat ients by reducing the time, radiation dose, and contrast required for the p rocedure. Subsequent surgery, which was required in both patients (due to f ailed embolization), was also greatly aided by the demonstration of the exa ct extent of the AVMs on axial CT images. Thus, CT angiography emerged as a n impressive non-invasive imaging modality for the complete evaluation and management of the uterine AVMs. (C) 2000 Elsevier Science Inc. All rights r eserved.