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. 2013;6(2):69-79.

Uterine vascular lesions

Abhishek Vijayakumar  1 , Amruthashree Srinivas, Babitha Moogali Chandrashekar, Avinash Vijayakumar
Affiliations

Uterine vascular lesions

Abhishek Vijayakumar et al. Rev Obstet Gynecol. 2013.

Abstract

Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management.

Keywords: Acquired AVM; Placental chorioangioma; Uterine arteriovenous fistula; Uterine arteriovenous malformations; Uterine hemangioma; Uterine pseudoaneurysm.

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Figures

Figure 1
Figure 1
Sonography of placental chorioangioma. A well-defined oval hypoechoic lesion arising from the fetal surface of the placenta with significant internal vascularity on Doppler; there is no evidence of calcification.
Figure 2
Figure 2
Magnetic resonance imaging signs of pelvic reflux from venous malformation. The maximum-intensity projection image demonstrates dilated parauterine varices filled due to passive reflux of contrast.
Figure 3
Figure 3
A pelvic angiogram demonstrating a well-visualized arteriovenous fistula (arrow) with the catheter in the artery and early filling veins; note the absence of nidus.
Figure 4
Figure 4
Pelvic angiogram showing pseudoaneurysm of the left uterine artery. The arrows indicate pseudoaneurysm with filling of contrast eccentrically. The arrowhead indicates the left uterine artery arising from the internal iliac artery.
Figure 5
Figure 5
Gray-scale trans-abdominal longitudinal ultrasound image of a uterus showing multiple anechoic areas within the myometrium of the anterior wall (arrow) displacing the thin, linear endometrium (arrowhead).
Figure 6
Figure 6
Power Doppler image depicting the color flow within the uterine arteriovenous malformation.
Figure 7
Figure 7
T2-weighted magnetic resonance image depicting a uterine arteriovenous malformation with extensive areas of signal void in the myometrium and serosal layer.
Figure 8
Figure 8
Pelvic angiogram showing uterine arteriovenous malformation with nidus formation.
See this image and copyright information in PMC

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