PMC8311842_01
Transvaginal grayscale ultrasound image of the uterus in sagittal plane demonstrates tubular hypoechoic areas within myometrium (white arrow), while colour Doppler shows the lesion of vascular origin (black arrows)
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fig1
Colour Doppler imaging demonstrated 8.8x5.5 x5.0 cm vascular lesion within myometrium with multiple arteriovenous shunts (Fig. 1).
(A) Pelvic angiography demonstrates hypervascular structure arising from the left uterine artery (arrow). (B) Selective angiography of the left internal iliac artery indicates a uterine AVM (arrow). (C) Image of venous phase demonstrates early draining vein (arrow). (D) Post-embolisation angiography reveals total occlusion of the left uterine artery (arrow) and absence of the previous AVM
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fig2
The post-embolisation angiography demonstrated that both uterine arteries had been occluded and resolution of vascular lesion had been achieved (Fig. 2). 
Transvaginal colour Doppler ultrasound image of the uterus in sagittal plane one month after embolisation demonstrates resolution of previous vascular lesion (white arrow), while hyperechoic mass within myometrium (black arrow) indicates embolic agent left post selective embolisation
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fig3
AVM (Fig. 3) and the patient reported prolonged menstruation already lasting one week. At six month follow-up visit no recurrence of abnormal vaginal bleeding or vascular lesion within myometrium was found.