Clinical features and characteristics of blood flow of uterine vascular abnormalities.
OBJECTIVE
The purpose of this study was to assess the clinical features and characteristics of the blood flow in uterine vascular abnormalities using ultrasound and magnetic resonance imaging (MRI).


METHODS
A total of 17 women were diagnosed with uterine vascular abnormalities by ultrasound. The clinical characteristics of the patients and the distribution and waveform of the intrauterine vessels were examined using transvaginal gray-scale and Doppler ultrasonography, spin-echo MRI, and MR angiography.


RESULTS
The average age of the 17 subjects was 44.3 years, and 5 were postmenopausal women. The number of pregnancies and deliveries was 2.0 and 1.7, respectively. Of the 17 subjects, 7 had a moderate or severe grade of dysmenorrhea and 7 had a history of vascular disease. In all subjects, vaginal ultrasound demonstrated tubular or numerous tortuous anechoic areas in the uterine wall, and Doppler ultrasound showed that the tubular or numerous dilated tortuous vessels had an atypical wave flow, unlike that of an artery or a vein. The distribution of displayed flow varied, and the waveforms of the Doppler ultrasound displayed three patterns. The averages of the pulse Doppler flow indices showed low impedance in the abnormal uterine vessel and the uterine artery, especially in cases of true arteriovenous malformations. MR angiography demonstrated distinct, tortuous, and coiled vascular channels in the pelvis during and just after the arterial phase.


CONCLUSIONS
Characterization of the clinical features of uterine vascular abnormalities is considered to be valuable for obstetricians and gynecologists.
Department of Obstetrics and Gynecology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, 470-1192, Japan. kurisen@zg7.so-net.ne.jp.
Takao
T
Sekiya
Department of Obstetrics and Gynecology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, 470-1192, Japan.
Haruki
H
Nishizawa
Department of Obstetrics and Gynecology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, 470-1192, Japan.
Naomi
N
Ozawa
Department of Obstetrics and Gynecology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, 470-1192, Japan.
Shin
S
Tada
Department of Obstetrics and Gynecology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, 470-1192, Japan.
Kiyoshi
K
Hasegawa
Department of Obstetrics and Gynecology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, 470-1192, Japan.
Yutaka
Y
Hirota
Faculty of Radiological Technology, Fujita Health University, School of Health Sciences, Toyoake, Japan.
Ryo-Ichi
R
Katoh
Department of Radiology, Fujita Health University, School of Medicine, Toyoake, Japan.
Tatsuo
T
Ban-No
Department of Obstetrics and Gynecology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, 470-1192, Japan.
Yasuhiro
Y
Udagawa
Doppler ultrasound; MRI; arteriovenous malformation; transvaginal ultrasound; uterine vascular abnormality; varicose vein