IMR Press / CEOG / Volume 50 / Issue 8 / DOI: 10.31083/j.ceog5008167
Open Access Systematic Review
Ultrasound Diagnosis of Uterine Arteriovenous Malformations: A Systematic Review
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1 Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain
2 Department of Obstetrics and Gynecology, Faculty of Medicine, University of Seville, 41004 Seville, Spain
3 Department of Obstetrics and Gynecology, Juan Ramón Jimenez Hospital, 41013 Huelva, Spain
*Correspondence: jgmejido@us.es (José Antonio García-Mejido)
Clin. Exp. Obstet. Gynecol. 2023, 50(8), 167; https://doi.org/10.31083/j.ceog5008167
Submitted: 21 March 2023 | Revised: 20 April 2023 | Accepted: 23 April 2023 | Published: 9 August 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Uterine arteriovenous malformations (UAVM) are especially relevant vascular abnormalities due to the vital risk that may stem from severe genital bleeding. The objective of this systematic review was to evaluate the ultrasound criteria for the diagnosis of UAVM and determine which ones are the consistently relevant for the diagnosis of UAVM. Methods: For this systemic review, we followed PRISMA 2020 guidelines. The systematic search was carried out in PubMed and Embase databases up to January 31st, 2023. The total amount of articles compiled with the search strategy was 3191. Results: 21 records met the inclusion criteria and were included in the review. The results revealed the heterogeneity in the studies on UAVM, as not all studies use the same ultrasound (US) features. Most of the included articles described data on US findings in the grayscale mode, which were variable and not specific for the diagnosis. In terms of color Doppler mapping and spectral Doppler analysis, the findings were consistent in all articles included, showing abnormal strong hypervascular lesions corresponding with a tangle of irregular vessels with multidirectional and strongly turbulent intraluminal flow. Conclusions: Ultrasound diagnosis of uterine arteriovenous malformations might be initially suspected in the grayscale mode, although the color and spectral Doppler assessment seems to be the key to achieving a consistent diagnosis with the visualization of a tangle of vessels in a ‘mosaic’ pattern with multidirectional turbulent flow in an arteriovenous shunting, with high-velocity and low-impedance values in spectral flow analysis.

Keywords
systematic review
uterine arteriovenous malformation
arteriovenous malformation
uterine vascular abnormalities
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