Sonographic features and management options of uterine arteriovenous malformation. Six cases report

Aslan, Halıl; Açar, Deniz; Ekiz, Ali; Kaya, Başak; Sezer, Salim; Ismayilzade, Reshad; Çan, Murat

doi:10.11152/mu.2013.2066.174.sgh

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…Grades III and IV hemorrhoids revealed blood flow with different directions which could be observed as a “mosaic pattern” (Figures 3 and 4, Table 2). In patients with grade III or IV hemorrhoids, color Doppler ultrasound showed multidirectional, turbulent flow consistent with an arteriovenous flow pattern, which seemed similar to the mosaic pattern mentioned in other studies of arteriovenous malformation[16,17]. In patients with grade III and IV hemorrhoids, the number of patients with the “mosaic pattern” as revealed by TRUS, TPUS, and TVUS was 22, 12, and 4, respectively.…”

Section: Resultssupporting

confidence: 82%

“…“Mosaic pattern” was a special blood flow with different directions. This special pattern was firstly reported by Aslan H[16], and described as “clover-leafed shape” in a pilot study reported by Zbar et al[34]. Color Doppler ultrasonography also indicated that “mosaic pattern” in the anal cushion area of hemorrhoids contained special blood signals.…”

Section: Discussionsupporting

confidence: 58%

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Sonographic appearance of anal cushions of hemorrhoids

Aimaiti¹,

Re²,

Ibrahim³

et al. 2017

WJG

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AIMTo evaluate the diagnostic value of different sonographic methods in hemorrhoids.METHODSForty-two healthy volunteers and sixty-two patients with grades I-IV hemorrhoids received two different sonographic examinations from January 2013 to January 2016 at the First and Second Hospitals of Xinjiang Medical University in a prospective way. We analyzed the ultrasonographic findings of these participants and evaluated the outcomes. Resected grades III and IV hemorrhoid tissues were pathologically examined. The concordance of ultrasonographic results with pathology results was assessed with the Cohen’s kappa coefficient.RESULTSAll healthy volunteers and all patients had no particular complications related to sonography. There were no statistically significant differences between the participants regarding age (P = 0.5919), gender (P = 0.4183), and persistent symptoms (P > 0.8692). All healthy control participants had no special findings. However, 30 patients with hemorrhoids showed blood signals around the dentate line on ultrasonography. When grades I and II hemorrhoids were analyzed, there were no significant differences between transrectal ultrasound (TRUS), transperianal ultrasound (TPUS), and transvaginal ultrasound (TVUS) (P > 0.05). Grades III and IV hemorrhoids revealed blood flow with different directions which could be observed as a “mosaic pattern”. In patients with grades III and IV hemorrhoids, the number of patients with “mosaic pattern” as revealed by TRUS, TPUS and TVUS was 22, 12, and 4, respectively. Patients with grades III and IV disease presented with a pathologically abnormal cushion which usually appeared as a “mosaic pattern” in TPUS and an arteriovenous fistula in pathology. Subepithelial vessels of resected grades III and IV hemorrhoid tissues were manifested by obvious structural impairment and retrograde and ruptured changes of internal elastic lamina. Some parts of the Trietz’s muscle showed hypertrophy and distortion. Arteriovenous fistulas and venous dilatation were obvious in the anal cushion of hemorhoidal tissues. After pathological results with arteriovenous fistulas were taken as the standard reference, we evaluated the compatibility between the two methods according to the Cohen’s kappa co-efficiency calculation. The compatibility (Cohein kappa co-efficiency value) between “mosaic pattern” in the TPUS and arteriovenous fistula in pathology was very good (ĸ = 0.8939). When compared between different groups, TRUS presented the advantage that the mosaic pattern could be confirmed in more patients, especially for group A. There was a statistical difference when comparing group A with group B or C (P < 0.05 for both). There were obvious statistical differences between group A and group B with regard to the vessel diameter and blood flow velocity measured by TRUS (P < 0.05).CONCLUSIONPatients with grades III and IV hemorrhoids present with a pathologically abnormal cushion which usually appears as a “mosaic pattern” in sonography, which is in accord with an arteriovenous fistula in path...

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Section: Resultssupporting

confidence: 82%

Section: Discussionsupporting

confidence: 58%

Sonographic appearance of anal cushions of hemorrhoids

Aimaiti¹,

Re²,

Ibrahim³

et al. 2017

WJG

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“…Although palpating a pulsatile mass and hearing loud or harsh noises on physical examination is a significant indication of pelvic AVM ( 2 ), not all masses may be palpable, and rectal examination is not routine. In addition, AVM might not be diagnosed during routine examination ( 14 ), contributing to a diagnostic dilemma.…”

Section: Discussionmentioning

confidence: 99%

“…Game et al ( 2 ) considered that US could only show a nonspecific hypoechogenic area and was not able to differentiate an AVM from a cyst or an abscess. Aslan et al ( 14 ) suggested that the US characteristics of AVM are nonspecific but could alert the sonographer to the possibility of a vascular abnormality. Although previous literature has reported congenital AVM diagnosed by transrectal US in which a pulsating mass was palpable on rectal examination, the US features of AVM were not described in detail ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

A male congenital pelvic arteriovenous malformation diagnosed by abdominal ultrasound: A case report and literature review

2023

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Congenital pelvic arteriovenous malformation (AVM) is a rare vascular abnormality whereby arteries and veins are directly connected with malformed vascular plexus. Owing to its low incidence and nonspecific symptoms, the ultrasonographic characteristics of congenital pelvic AVM in males have been infrequently studied. A 30-year-old man visited our hospital complaining of progressive pain in the right lower abdomen and lumbar area since 2 months previously. Abdominal ultrasound (US) was performed at the initial examination and pelvic AVM was diagnosed, which was then confirmed by computed tomographic angiography. After right internal iliac artery embolization, the patient recovered uneventfully and remained asymptomatic during the 12-month follow-up period. Congenital pelvic AVM should thus be included in the differential diagnosis of pelvic cystic masses in males despite its low incidence, with US also being of great diagnostic value. We describe the ultrasonic features of AVM in detail and hope that this study may contribute to the ultrasonic diagnosis of congenital pelvic AVM in males.

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“…Uterine arteriovenous malformation (AVM) is a rare and potentially fatal source of uterine bleeding due to abnormal vascular connections between arteries and veins. While the prevalence is unknown due to limited reported cases, 1 an observational study on 265 patients with abnormal premenopausal bleeding showed an incidence of 3.4% by ultrasound. 2 Uterine AVMs typically present in women of reproductive age; however, they can infrequently appear after menopause.…”

Section: Introductionmentioning

confidence: 99%

Rare occurrence of uterine arteriovenous malformation clinically mimicking a malignant growth: A critical reminder for pathologists

Lollie¹,

Raman²,

Qorbani³

et al. 2020

Autops. Case Rep.

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Arteriovenous malformation (AVM) is a rare lesion in the uterus, which can lead to abnormal uterine bleeding. While AVM has been described in other organs in the literature, there is a paucity of pathology reports of the AVM in uterus. On gross examination, the uterus was markedly enlarged and partly distorted with a pedunculated solid mass, which on the cut surface showed multiple well-circumscribed hemorrhagic cysts ranging from 0.1 to 4.0 cm in size. Microscopically, they were malformed dilated vascular structures containing organized thrombi. We present this case of uterine AVM with gross and microscopic findings, which can serve as a crucial reminder for pathologists to keep in the differential diagnoses as a potential cause of abnormal uterine bleeding.

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Sonographic features and management options of uterine arteriovenous malformation. Six cases report

Cited by 9 publications

References 15 publications

Sonographic appearance of anal cushions of hemorrhoids

Sonographic appearance of anal cushions of hemorrhoids

A male congenital pelvic arteriovenous malformation diagnosed by abdominal ultrasound: A case report and literature review

Rare occurrence of uterine arteriovenous malformation clinically mimicking a malignant growth: A critical reminder for pathologists

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