Arteriovenous malformation of mesosalpinx associated with a 'vanishing' ectopic pregnancy: diagnosis with three-dimensional color power angiography.
We describe two cases of pelvic arteriovenous malformation diagnosed with the aid of three-dimensional color power angiography. In both cases, beta-human chorionic gonadotropin (beta-hCG) increased to significant levels (8413 and 1560 mIU/ml, respectively); however, neither an intrauterine nor an adnexal gestational sac could be found. In each case, we observed an adnexal mass with several tortuous areas exhibiting abundant turbulent flow. The diagnosis of arteriovenous malformation was made and further assessment by three-dimensional color power angiography and magnetic resonance imaging (MRI) was carried out. The complex vascular anatomy of arteriovenous malformation, including its feeding vessels and drainage, was clearly depicted by three-dimensional color power angiography and correlated well with magnetic resonance angiography. Levels of beta-hCG decreased in subsequent tests, and eventually became negative 2-3 months later without and intervention. We believe that an involutional ectopic pregnancy induced the rapid growth of the arteriovenous malformations within the mesosalpinx. Three-dimensional color power angiography can be performed quickly and easily, using existing ultrasound equipment. It improves our understanding of complicated vasculature, and thus is a useful adjunct to two-dimensional and color Doppler ultrasound in the diagnosis of arteriovenous malformation.
Shih
J C
JC
Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Hospital, Taipei.
Shyu
M K
MK
Cheng
W F
WF
Lee
C N
CN
Jou
H J
HJ
Wang
R M
RM
Hsieh
F J
FJ
D000328:Adult; D000792:Angiography / Q000379:methods*; D001165:Arteriovenous Malformations / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D001783:Blood Flow Velocity; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005187:Fallopian Tubes / Q000098:blood supply* / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal
D018997:Chorionic Gonadotropin, beta Subunit, Human