Congenital renal arteriovenous fistula during the first trimester diagnosed with ultrasonography.
A case of congenital renal arteriovenous fistula (AVF) complicating pregnancy with gross hematuria was managed successfully by superselective embolization with metallic coils. The patient was in the first trimester of her pregnancy at 12 weeks of gestation. The AVF was detected by color Doppler sonography and confirmed by renal arteriography. Because of its easy accessibility and absence of irradiation, ultrasound is the first choice for pregnant patients. Color Doppler ultrasound is effective in diagnosing AVF, and it is also helpful in the long-term followup after treatment. The cirsoid-type renal congenital arteriovenous fistula has a characteristic sonographic appearance with a cluster of tubular anechoic structures in the kidney, which produce continuous turbulent high-velocity flow signals and a burr-like boundary flow spectrum. When the sonographic features are present, the diagnosis of renal AVF should be made, after which renal arteriography can be performed to confirm it. Selective embolization provided a safe and effective treatment with minimal damage to the parenchyma and without compromising renal function.
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jeifang Ave, Wuhan, 430022, Hubei, China.
Mengyun
M
Yao
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jeifang Ave, Wuhan, 430022, Hubei, China.
Qiuyan
Q
Zhang
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jeifang Ave, Wuhan, 430022, Hubei, China.
Jing
J
Wang
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jeifang Ave, Wuhan, 430022, Hubei, China.
Feixiang
F
Xiang
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jeifang Ave, Wuhan, 430022, Hubei, China.
Cheng
C
Yu
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jeifang Ave, Wuhan, 430022, Hubei, China.
Qing
Q
Lv
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jeifang Ave, Wuhan, 430022, Hubei, China. xiemx64@126.com.
Mingxing
M
Xie
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jeifang Ave, Wuhan, 430022, Hubei, China. zhyr008@aliyun.com.
Yanrong
Y
Zhang
D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000628:therapy*; D012077:Renal Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D012082:Renal Veins / Q000002:abnormalities / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods
Arteriovenous fistula; Congenital; Embolization; Pregnancy; Renal artery; Ultrasonography