Figure 5d. Acquired AVM in a 30-year-old woman. The patient had intermittent vaginal bleeding after D&C for a therapeutic abortion 110 days earlier. The serum ß-HCG test was negative at presentation. (a) Transverse gray-scale US image shows subtle myometrial inhomogeneity (arrows) with a small internal anechoic component in the right posterolateral wall of the uterus. (b) Transverse color Doppler US image shows a tangle of tortuous vessels (arrows) in the corresponding myometrium. (c) Transverse duplex Doppler US image shows high-velocity arterial flow with a high diastolic component (PSV, 63 cm/sec; RI, 0.19). (d) Selective angiogram of the right uterine artery obtained during the arterial phase shows a markedly opacified vascular tangle (arrows) and early venous drainage (arrowheads). After embolization with absorbable gelatin sponge pledgets, no bleeding recurred.