Accuracy of Flow-void Diameters on MR Images in Diagnosing Uterine Arteriovenous Malformations in Patients With Pregnancy-related Diseases

Abstract

Objective(s): To evaluate the “flow void” diameter in patients with pregnancy-related diseases with and without uterine AVMs and assess the diagnostic performance of unenhanced MRI for uterine AVMs.Study Design: From May 2014 to April 2019, 79 patients with pregnancy-related diseases were included, including 36 with and 43 without uterine AVMs confirmed by DSA. On MRI, the diameter of the most prominent “flow void” (hereinafter referred to as fv-D) was measured and compared between patients with and without uterine AVMs. The diagnostic performance of fv-D was estimated with receiver operating characteristic curves.Results: The “flow void” sign was observed in patients with and without uterine AVMs (P>0.05). The fv-D was significantly larger in patients with uterine AVMs in the myometrium and parametrium than in patients without uterine AVMs (P<0.0001). The fv-D achieved a reliable diagnostic performance in the myometrium (sensitivity: 80.56%, specificity: 60.27%, AUC: 0.727, cut-off:>1.33 mm) and parametrium (sensitivity: 97.22%, specificity: 67.44%, AUC: 0.881, cut-off:>2.6 mm). Conclusions: On MRI, fv-D could diagnose uterine AVMs. The fv-D had a much higher diagnostic efficiency in the parametrium than in the myometrium. The parametrium fv-D greatly improved the diagnostic sensitivity and provides a more accurate, noninvasive method of investigating possible uterine AVMs.