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Color Doppler US in the Evaluation of Uterine Vascular Abnormalities¹

Pnar Polat, MD, Selami Suma, MD, Mecit Kantarc, MD, Fatih Alper, MD and Akn Levent, MD

¹ From the Department of Radiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey. Received February 28, 2001; revision requested April 4 and final revision received July 7; accepted July 23. Address correspondence to P.P. (e-mail: drppolat@hotmail.com).

View larger version (144K): [in a new window]   Figure 1a.   Uterine AVM in a 22-year-old woman who had undergone curettage on several occasions for spontaneous abortion. Evaluation of hysterectomy material had confirmed the presence of a malformation. (a) Transabdominal gray-scale US image shows multiple anechoic spaces. (b, c) Color Doppler US images show a mosaic pattern of color signals within the cystic spaces. (b) Spectral analysis of the arterial vessels within the lesion shows high blood flow velocity with a low resistive index. (c) Spectral analysis of venous flow shows high blood flow velocities and peak systolic velocities, findings similar to those seen in b.

View larger version (105K): [in a new window]   Figure 1b.   Uterine AVM in a 22-year-old woman who had undergone curettage on several occasions for spontaneous abortion. Evaluation of hysterectomy material had confirmed the presence of a malformation. (a) Transabdominal gray-scale US image shows multiple anechoic spaces. (b, c) Color Doppler US images show a mosaic pattern of color signals within the cystic spaces. (b) Spectral analysis of the arterial vessels within the lesion shows high blood flow velocity with a low resistive index. (c) Spectral analysis of venous flow shows high blood flow velocities and peak systolic velocities, findings similar to those seen in b.

View larger version (112K): [in a new window]   Figure 1c.   Uterine AVM in a 22-year-old woman who had undergone curettage on several occasions for spontaneous abortion. Evaluation of hysterectomy material had confirmed the presence of a malformation. (a) Transabdominal gray-scale US image shows multiple anechoic spaces. (b, c) Color Doppler US images show a mosaic pattern of color signals within the cystic spaces. (b) Spectral analysis of the arterial vessels within the lesion shows high blood flow velocity with a low resistive index. (c) Spectral analysis of venous flow shows high blood flow velocities and peak systolic velocities, findings similar to those seen in b.

View larger version (177K): [in a new window]   Figure 2a.   Left uterine artery aneurysm in an 18-year-old woman with habitual abortion. (a) Real-time gray-scale US image shows an anechoic lesion in the myometrium (arrow). (b) Power Doppler US image shows color signal within the lesion. (c) Color Doppler US image with spectral analysis demonstrates the lesion with a typical arterial flow pattern. (d) Arteriogram of the left common iliac artery shows a saccular aneurysm that protrudes from the left uterine artery.

View larger version (141K): [in a new window]   Figure 2b.   Left uterine artery aneurysm in an 18-year-old woman with habitual abortion. (a) Real-time gray-scale US image shows an anechoic lesion in the myometrium (arrow). (b) Power Doppler US image shows color signal within the lesion. (c) Color Doppler US image with spectral analysis demonstrates the lesion with a typical arterial flow pattern. (d) Arteriogram of the left common iliac artery shows a saccular aneurysm that protrudes from the left uterine artery.

View larger version (104K): [in a new window]   Figure 2c.   Left uterine artery aneurysm in an 18-year-old woman with habitual abortion. (a) Real-time gray-scale US image shows an anechoic lesion in the myometrium (arrow). (b) Power Doppler US image shows color signal within the lesion. (c) Color Doppler US image with spectral analysis demonstrates the lesion with a typical arterial flow pattern. (d) Arteriogram of the left common iliac artery shows a saccular aneurysm that protrudes from the left uterine artery.

View larger version (143K): [in a new window]   Figure 2d.   Left uterine artery aneurysm in an 18-year-old woman with habitual abortion. (a) Real-time gray-scale US image shows an anechoic lesion in the myometrium (arrow). (b) Power Doppler US image shows color signal within the lesion. (c) Color Doppler US image with spectral analysis demonstrates the lesion with a typical arterial flow pattern. (d) Arteriogram of the left common iliac artery shows a saccular aneurysm that protrudes from the left uterine artery.

View larger version (144K): [in a new window]   Figure 3a.   Right uterine artery pseudoaneurysm in a 20-year-old woman with infection that was proved at hysterectomy. The patient had undergone curettage on several occasions. (a) Transabdominal gray-scale US image shows an anechoic lesion in the uterus. (b) Transverse color Doppler US image shows a pseudoaneurysm that originates from the right uterine artery. Color signals within the arterial lumen represent turbulent flow.

View larger version (137K): [in a new window]   Figure 3b.   Right uterine artery pseudoaneurysm in a 20-year-old woman with infection that was proved at hysterectomy. The patient had undergone curettage on several occasions. (a) Transabdominal gray-scale US image shows an anechoic lesion in the uterus. (b) Transverse color Doppler US image shows a pseudoaneurysm that originates from the right uterine artery. Color signals within the arterial lumen represent turbulent flow.

View larger version (145K): [in a new window]   Figure 4a.   Placental chorioangioma in a 35-year-old pregnant woman in the 24th week of gestation. (a) Transabdominal gray-scale US images show a well-defined hypoechoic mass containing multiple cystic spaces that protrudes from the fetal surface of the anterior placenta. (b) Color Doppler US image shows color signals in the cystic spaces. Spectral analysis shows arterial flow within the lesion. (c) Color Doppler US image of a different vessel with spectral analysis reveals venous flow within the lesion.

View larger version (112K): [in a new window]   Figure 4b.   Placental chorioangioma in a 35-year-old pregnant woman in the 24th week of gestation. (a) Transabdominal gray-scale US images show a well-defined hypoechoic mass containing multiple cystic spaces that protrudes from the fetal surface of the anterior placenta. (b) Color Doppler US image shows color signals in the cystic spaces. Spectral analysis shows arterial flow within the lesion. (c) Color Doppler US image of a different vessel with spectral analysis reveals venous flow within the lesion.

View larger version (119K): [in a new window]   Figure 4c.   Placental chorioangioma in a 35-year-old pregnant woman in the 24th week of gestation. (a) Transabdominal gray-scale US images show a well-defined hypoechoic mass containing multiple cystic spaces that protrudes from the fetal surface of the anterior placenta. (b) Color Doppler US image shows color signals in the cystic spaces. Spectral analysis shows arterial flow within the lesion. (c) Color Doppler US image of a different vessel with spectral analysis reveals venous flow within the lesion.