Radiological findings of uterine arteriovenous
                    malformation: a case report of an unusual and life-threatening cause of abnormal
                    vaginal bleeding

Uterine arteriovenous malformations may cause life-threatening abnormal genital bleeding in women at childbearing age. Transvaginal Doppler ultrasonography is a widely available, noninvasive and excellent diagnostic method. The authors report the case of a patient with history of gestational trophoblastic disease and multiple curettage procedures who developed uterine arteriovenous malformations, with remission of the lesions after treatment with methotrexate.

Arteriovenous malformations; Doppler; Abnormal genital bleeding

Authorship

Marcela Sales Farias

MDs, Residents of Radiology and Imaging Diagnosis, Universidade Federal do Espírito Santo (UFES) / Hospital Universitário Cassiano Antonio Moraes (Hucam), Vitória, ES, BrazilUniversidade Federal do Espírito Santo (UFES)BrazilVitória, ES, BrazilMDs, Residents of Radiology and Imaging Diagnosis, Universidade Federal do Espírito Santo (UFES) / Hospital Universitário Cassiano Antonio Moraes (Hucam), Vitória, ES, Brazil

Clara Campagnaro Santi

Aline Aparecida A. de A. Lima

MD, Resident of Gynecology and Obstetrics, Universidade Federal do Espírito Santo (UFES) / Hospital Universitário Cassiano Antonio Moraes (Hucam), Vitória, ES, BrazilUniversidade Federal do Espírito Santo (UFES)ES, BrazilMD, Resident of Gynecology and Obstetrics, Universidade Federal do Espírito Santo (UFES) / Hospital Universitário Cassiano Antonio Moraes (Hucam), Vitória, ES, Brazil

Sabrina Mendes Teixeira

MD, Gynecologist and Obstetrician, Resident of Ultrasonography in Gynecology and Obstetrics, Universidade Federal do Espírito Santo (UFES) / Hospital Universitário Cassiano Antonio Moraes (Hucam), Vitória, ES, BrazilUniversidade Federal do Espírito Santo (UFES)ES, BrazilMD, Gynecologist and Obstetrician, Resident of Ultrasonography in Gynecology and Obstetrics, Universidade Federal do Espírito Santo (UFES) / Hospital Universitário Cassiano Antonio Moraes (Hucam), Vitória, ES, Brazil

Tatiana Co Gomes De Biase

MD, Gynecologist and Sonographer, Preceptor of Ultrasonography in Gynecology and Obstetrics and Radiology and Imaging Diagnosis, Universidade Federal do Espírito Santo (UFES) / Hospital Universitário Cassiano Antonio Moraes (Hucam), Vitória, ES, BrazilUniversidade Federal do Espírito Santo (UFES)ES, BrazilMD, Gynecologist and Sonographer, Preceptor of Ultrasonography in Gynecology and Obstetrics and Radiology and Imaging Diagnosis, Universidade Federal do Espírito Santo (UFES) / Hospital Universitário Cassiano Antonio Moraes (Hucam), Vitória, ES, Brazil

Mailing Address: Dra. Marcela Sales Farias. Rua Doutor Delmiro Coimbra, 80, cobertura 2A, Mata da Praia. Vitória, ES, Brazil, 29065-360. E-mail: lelasf@gmail.com

*
Study developed at Hospital Universitário Cassiano Antonio Moraes (Hucam) – Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil.

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (4)

Thumbnail

Figure 1.
Gray scale transvaginal US demonstrating uterus increased in volume with heterogeneous myometrial echotexture due to the presence of multiple anechoic images. The largest of such images is located on the left lateral wall (arrow).

Thumbnail

Figure 2.
Gray scale transvaginal US demonstrating the presence of a large, anechoic, intramyometrial mass (A). Color Doppler study demonstrated turbulent flow within the mass (B).

Thumbnail

Figure 3.
Transvaginal color Doppler US demonstrating intense myometrial hypervascularization with turbulent flow.

Thumbnail

Figure 4.
Pelvic MRI – sagittal (A, D), axial (B) and coronal (C), T2-weighted TSE sequences. The images show the uterus increased in volume, with multiple vascular-like serpiginous structures characterized by flow void (arrow on A). In the fundus/left lateral wall of the uterus, a round-shaped lesion with similar characteristics corresponding to a voluminous arteriovenous fistula (arrow on B). Also, the presence of prominent parametrial vessels is observed at right (arrows on C and D). V, vaginal cavity distended by gel.

Figure 1. Gray scale transvaginal US demonstrating uterus increased in volume with heterogeneous myometrial echotexture due to the presence of multiple anechoic images. The largest of such images is located on the left lateral wall (arrow).

Figure 2. Gray scale transvaginal US demonstrating the presence of a large, anechoic, intramyometrial mass (A). Color Doppler study demonstrated turbulent flow within the mass (B).

Figure 3. Transvaginal color Doppler US demonstrating intense myometrial hypervascularization with turbulent flow.

Figure 4. Pelvic MRI – sagittal (A, D), axial (B) and coronal (C), T2-weighted TSE sequences. The images show the uterus increased in volume, with multiple vascular-like serpiginous structures characterized by flow void (arrow on A). In the fundus/left lateral wall of the uterus, a round-shaped lesion with similar characteristics corresponding to a voluminous arteriovenous fistula (arrow on B). Also, the presence of prominent parametrial vessels is observed at right (arrows on C and D). V, vaginal cavity distended by gel.

How to cite

copy

Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem Av. Paulista, 37 - 7º andar - conjunto 71, 01311-902 - São Paulo - SP, Tel.: +55 11 3372-4541, Fax: 3285-1690, Fax: +55 11 3285-1690 - São Paulo - SP - Brazil
E-mail: radiologiabrasileira@cbr.org.br

Acompanhe os números deste periódico no seu leitor de RSS

Versão para download de PDF

PDF

Inglês
Português

Versões e tradução automática

Versão original do texto

English
Português

Tradução automática

Google Translator
Microsoft Translator

Como citar

RIS

BIBTEX

Outros formatos de citação e exportação:

SciELO - Scientific Electronic Library Online
Rua Dr. Diogo de Faria, 1087 – 9º andar – Vila Clementino 04037-003 São Paulo/SP - Brasil
E-mail: scielo@scielo.org