Presentation
Vaginal bleeding after evacuation of molar pregnancy
Patient Data
Multiple tortuous anechoic channels are noted traversing the whole thickness of the uterine wall. By color Doppler, they show intense filling and aliasing. These vascular spaces exhibit machinery low resistance unidirectional flow by pulsed wave Doppler. A feeding branch from the uterine artery is seen supplying these vessels.
Multiple serpiginous signal void structures traverse the whole myometrium and extend to the left adnexal region. Some show an intense enhancement in the post-contrast study, while others remain signal-void.
Case Discussion
Arteriovenous malformations appear in magnetic resonance as serpiginous signal void structures due to high velocities. They show color aliasing due to flow turbulence by color Doppler, and low resistance flow by pulsed-wave Doppler. This is a case of uterine arteriovenous malformation following the evacuation of a molar pregnancy one year before. The patient experienced continuous bleeding per vagina. The quantitative human chorionic gonadotropin count was not high excluding a residual gestational trophoblastic neoplasm.
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