Arteriography of trophoblastic tumours

Cockshott, W. Peter; Evans, Katharine; Hendrickse, J. P. De V.

doi:10.1016/s0009-9260(64)80043-x

Cited by 48 publications

(9 citation statements)

References 9 publications

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“…In each of these entities, uterine arteriovenous communications have been described. 14,15 The diagnosis of a uterine AVM should be based on pertinent patient history, negative β-hCG findings, and the characteristic color/spectral Doppler findings.…”

Section: A B Discussionmentioning

confidence: 99%

Uterine arteriovenous malformations: from diagnosis to treatment

Brien

Neyestani

Chang

et al. 2003

Ultrasound in Medicine & Biology

103

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Objective. The purpose of this study was to describe the sonographic features of uterine arteriovenous malformations (AVMs) and to describe the role and clinical outcome after transcatheter arterial embolization of symptomatic uterine AVMs. Methods. In our institution, over a 4-year period, symptomatic uterine AVMs were diagnosed in 21 women. Endovaginal sonography with gray scale, color, and spectral Doppler imaging was performed on all patients. Fourteen patients required therapeutic angiography/embolization to control bleeding. These 14 patients had follow-up endovaginal sonography 24 hours after the procedure. Results. The sonographic gray scale findings of uterine AVMs were nonspecific. The most common finding was subtle myometrial heterogeneity (n = 14), whereas other patients had small anechoic spaces in the myometrium (n = 7). Color Doppler sonography showed a tangle of vessels with multidirectional high-velocity flow that produced a "color mosaic" pattern. Spectral Doppler analysis showed arteriovenous shunting with high-velocity, low-resistance flow. Fourteen patients required transcatheter arterial embolization to control bleeding. Thirteen of 14 patients had no sonographic evidence of a residual AVM 24 hours after the procedure. One of 14 patients had a residual AVM requiring additional embolization. One patient had recurrent bleeding at 4 months and required further embolization. The remaining 7 patients were treated conservatively. Conclusions. Endovaginal sonography is the imaging modality of choice in patients with abnormal uterine bleeding. Routine use of color and spectral Doppler sonography allows one to confidently make the correct diagnosis. Transcatheter arterial embolization is an excellent treatment option. Endovaginal sonography should be used to monitor postembolization outcomes.

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Section: A B Discussionmentioning

confidence: 99%

Uterine arteriovenous malformations: from diagnosis to treatment

Brien

Neyestani

Chang

et al. 2003

Ultrasound in Medicine & Biology

103

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show abstract

“…In pregnancy, arteriovenous communication is more common in GTD, especially malignant GTD. 6 The AVMs develop as a result of destruction of the uterine vasculature by trophoblastic invasion of the myometrium by spiral arteries. 7 The sonographic features of AVM are often indistinguishable from those seen in GTD.…”

Section: Discussionmentioning

confidence: 99%

Retained products of conception mimicking a large endometrial AVM: Complete resolution following spontaneous abortion

Jain

Fogata

2006

J of Clinical Ultrasound

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ABSTRACT:We report an unusual appearance of retained products of conception that mimicked an arteriovenous malformation. A 38-year-old woman presented with persistent scant vaginal bleeding and declining levels of serum beta-HCG after therapeutic abortion. Sonographic examination revealed a highly vascular lobulated mass, which on spectral Doppler examination showed low resistance and high peak systolic velocity suggestive of arteriovenous shunting. The patient spontaneously passed tissue per vagina, after which the endometrial vascular mass completely disappeared, indicating that the sonographic abnormality was the retained products of conception. The pathologic basis for such a finding is discussed.

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“…Under these circumstances, pregnancy‐related conditions such as intrauterine pregnancy, ectopic pregnancy, retained products of conception, or gestational trophoblastic disease should be considered. A combination of history of the specific pattern of vaginal bleeding, a negative pregnancy test and characteristic features on colour and spectral Doppler should be used to diagnose uterine AVMs …”

Section: Clinical Manifestationmentioning

confidence: 99%

“…A combination of history of the specific pattern of vaginal bleeding, a negative pregnancy test and characteristic features on colour and spectral Doppler should be used to diagnose uterine AVMs. 30,31 Investigations Traditionally, uterine AVMs were diagnosed after hysterectomy with histopathologic evidence of the arteriovenous fistulas. 10,32 The gold standard for diagnosis of uterine AVMs is digital subtraction pelvic angiography.…”

Section: Clinical Manifestationmentioning

confidence: 99%

Uterine arteriovenous malformations: clinical implications

Annaiah

Sreenivasan

2015

The Obstetric & Gynaecologis

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Key content The incidence and prevalence of uterine arteriovenous malformations (AVMs) is difficult to determine because bleeding caused by uterine AVMs does respond to medical management and several of these may go undiagnosed. Fewer than 100 cases have been reported in the literature, but the increasing use of imaging modalities, particularly ultrasound, in acute gynaecology is likely to lead to identification of these lesions more frequently. Uterine AVMs are largely acquired lesions, with pregnancy playing an important role in their pathogenesis. The most frequent clinical manifestation is abnormal uterine bleeding, which can often be episodic, torrential and can result in significant anaemia or even shock. Hysterectomy remains the most definitive treatment, however, modern management of uterine AVMs varies from medical management (hormonal therapy), through minimally invasive uterine artery embolisation to more definitive surgical hysterectomy. Learning objectives To be aware of the existence of these lesions and to understand the risk factors and clinical presentation of women who should be suspected of having these lesions. To learn the various conservative treatment options for the management of uterine AVMs. To understand the implications for women's future fertility. Ethical issues Should ultrasound Doppler be routinely performed in women who have persistent vaginal bleeding after management of miscarriage? Since experience with interpreting angiography to diagnose uterine AVM is limited, should those women with suspected uterine AVM requiring surgical management be referred to a tertiary centre?

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Arteriography of trophoblastic tumours

Cited by 48 publications

References 9 publications

Uterine arteriovenous malformations: from diagnosis to treatment

Uterine arteriovenous malformations: from diagnosis to treatment

Retained products of conception mimicking a large endometrial AVM: Complete resolution following spontaneous abortion

Uterine arteriovenous malformations: clinical implications

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