Affiliation:
1. Keimyung University, Dongsan Hospital, Department of Radiology, Republic of Korea
2. Kyungbook National University Hospital, Department of Radiology, Republic of Korea
Abstract
Background Uterine arteriovenous malformations (AVMs) are known to spontaneously regress. Purpose To assess the predictive value of ultrasonography for patients requiring conservative treatment for pregnancy related to AVMs. Material and Methods Our prospective study included 75 patients (conservative management:therapeutic management = 45:30) with vaginal bleeding from pregnancy-related AVM. Clinical and ultrasonography examinations were reviewed, and the following information was gathered: complete blood count, AVM maximal diameter, AVM echogenicity, retained product of conception, number of blood vessels, and spectral Doppler (pulsatility index [PI], resistance index [RI], peak systolic velocity [PSV], time-averaged maximum velocity [TAMXV]). The Doppler criteria by Timmerman (mean PSV >70 cm/s: therapeutic management, mean PSV < 52 cm/s: conservative management) were used for the initial management selection. The association between experimental variables and outcomes was assessed to determine their usefulness for predicting conservative management. Results Features strongly associated with conservative management and their accuracy were PSV 89.6%, hemoglobin 84.7%, RI 83.1%, TAMXV 79.3%, and PI 78.6%. The overall accuracy for correct outcome classification was 64 (85.3%) of 75 patients. Most patients with conservative management had quicker improvement of symptoms and spontaneous regression at follow-up. Conclusion Ultrasonography can accurately predict selection of conservative management.
Subject
Radiology Nuclear Medicine and imaging,General Medicine,Radiological and Ultrasound Technology
Cited by
20 articles.
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