PMC5359997_01
A 25-year-old female with uterine arteriovenous malformation who presented with postcoital vaginal bleeding. Transabdominal gray-scale ultrasound image of uterus showing myometrial heterogeneity with multiple anechoic cystic structures (arrow).
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F1
Transabdominal ultrasonography (USG) showed bulky uterus with cystic areas within it [Figure 1].
A 25-year-old female with uterine arteriovenous malformation who presented with postcoital vaginal bleeding. Doppler ultrasound image of uterus shows typical mosaic pattern signals (arrow) with the spectral analysis revealing a high-velocity flow with low-resistance index suggesting arteriovenous malformation
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F2
Color Doppler imaging demonstrated multiple tortuous vascular channels and spaces in intramyometrial and in bilateral parametrial region with flow in both arterial and venous phase [Figure 2].
(a) Contrast-enhanced computed tomography scan of pelvic cavity in a woman with uterine arteriovenous malformation. The coronal volume rendered image shows multiple serpiginous vascular channels in the uterus and parametrium with multiple feeders from bilateral gonadal arteries (arrow) and internal iliac arteries suggesting arteriovenous malformation. (b) Contrast-enhanced computed tomography scan of pelvic cavity in a woman with uterine arteriovenous malformation. The sagittal maximum intensity projection shows multiple serpiginous enhancing vascular channels (arrow) within the myometrium and parametrium suggesting arteriovenous malformations.
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F3
CT-angiography revealed a large AVM involving the uterus, bilateral parametria, and vagina [Figure 3b]. There were multiple arterial feeders from bilateral internal iliac arteries, aorta including bilateral gonadal arteries, multiple lumbar arteries, and bilateral common femoral arteries [Figure 3a].
(a) Digital subtraction angiography image of uterus in a woman with uterine arteriovenous malformation. Preembolization image with selective catheterization of the left internal iliac artery and run shows contrast blush (white arrow) within arteriovenous malformation and early draining veins (black arrow) suggesting abnormal communicating blood vessels. (b) Digital subtraction angiography image of uterus in a woman with uterine arteriovenous malformation. This post embolization image with run shows glue cast (arrow) and no contrast blush suggesting sealing arteriovenous malformation by glue.
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Embolization was carried out with 3 ml of 50% cyanoacrylate glue in view of large caliber of vascular channels with high flow in it [Figure 4a and b].
Chest X-ray (posteroanterior view) of a woman with uterine arteriovenous malformation. She had undergone glue embolization and developed shortness of breath immediately after the procedure. Chest X-ray shows multiple branching patterns of linear radio densities (arrow) scattered in the bilateral lungs and prominent pulmonary bay suggesting glue embolization.
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F5
Features were suggestive of particulate emboli [Figure 5].
Contrast-enhanced computed tomography scan of chest in a woman with uterine arteriovenous malformation and glue embolization. The axial image of computed tomography chest shows the presence of linear hyperdensities within the segmental branches of bilateral pulmonary artery (arrow) suggesting glue embolization in the pulmonary artery.
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Computed tomography pulmonary angiography revealed multiple hyper dense filling defects in segmental branches of the right upper lobe and subsegmental branches of the right and left pulmonary arteries secondary to glue embolism [Figure 6].