Application of color Doppler ultrasound in acquired arteriovenous malformations

Abstract

Objective To investigate the characteristics of two dimensional ultrasound and Doppler ultrasound in acquired uterine arteriovenous malformations (AVM), and to analyze their value in the observation of curative effect after uterine artery embolization. Methods Eleven patients with acquired uterine AVM were selected as the study subjects. Retrospective analysis was made on the two-dimensional sonographic and color Doppler flow imaging (CDFI) performance of the uterus and lesion area, and quantitative analysis was made on its Doppler waveform characteristics, including peak systolic velocity (PSV) and resistance index (RI), combined with clinical symptoms and the changes in the sonogram of the lesion after uterine artery embolization. Results All 11 patients were diagnosed as uterine AVM by color Doppler ultrasound. Two-dimensional ultrasound images showed a single rounded anechoic area and/or multiple small anechoic areas with hypoechoic honeycomb-like area in the myometrium, while their color Doppler showed that there was a rich red-blue mosaic blood flow signal filling in the anechoic zone, showing a mosaic or lake-like change; Doppler waveform showed a high-speed, low-impedance blood flow spectrum, and 11 cases of ultrasound examination results and uterine artery angiography results were basically consistent. All patients underwent UAE treatment. Ten patients were re-examined at 1 week to 6 months after embolization. Two-dimensional ultrasound showed significant reduction or gradual disappearance. The color Doppler ultrasound showed low-velocity venous blood flow signal or abnormal blood flow signal disappearance compared with before treatment. One case followed up at 1 week to 11 months after embolization showed lesions reduced but low-speed and low-resistance arterial spectrum persisted, and recurrent bleeding occurred after re-embolization. The patient eventually had her uterus removed due to no fertility requirements. Conclusions Color Doppler ultrasound has significant importance in the diagnosis of acquired AVMs and in monitoring the efficacy of embolotherapy in patients with acquired uterine AVMs. Key words: Ultrasonography, color Doppler; Arteriovenous malformations; Uterine artery embolization