Variable color Doppler sonographic appearances of retained products of conception: radiologic-pathologic correlation

Abstract

Histologic vascularity of villi appears to contribute to the observed variation in sonographic vascularity. This finding may underlie known differences in clinical outcomes between sonographic vascularity groups.

Color Doppler Imaging of Vascular Abnormalities of the Uterus

“…Retained products of conception on US are suggested when the endometrial echo complex is thickened greater than 1 cm or the cavity is distended by an intrauterine mass. 24,25 When the endometrial stripe is greater than 1 cm in thickness, color Doppler interrogation helps determine the degree of suspicion of RPOC. Although vascularity of histologically confirmed RPOC can be variable, highly vascular echogenic tissue is strongly suggestive of RPOC.…”

“…5) of vascularity have been described: avascular (type 0), minimal (type 1; less than adjacent myometrium), moderate (type 2; similar to myometrial vascularity), and marked (type 3; marked arterial vascularity much greater than myometrium). 24 Stratifying the vascularity of suspected RPOC can help facilitate decision making, 25,27 and Doppler US serves as an excellent tool to provide this information.…”

“…After 24 hours of prolonged bleeding, retained products of conception (RPOC) becomes more of a concern as a potential etiology of bleeding, and pelvic US at this point can be helpful for further investigation. Retained products of conception on US are suggested when the endometrial echo complex is thickened greater than 1 cm or the cavity is distended by an intrauterine mass 24,25 . When the endometrial stripe is greater than 1 cm in thickness, color Doppler interrogation helps determine the degree of suspicion of RPOC.…”