Uterine Vascular Abnormalities (AVM congenital and Acquired); Teaching Point for Radiologist

Acquired Arteriovenous Malformation (AVM), also referred to as Enhanced Myometrial Vascularity (EMV) is a vascular lesion associated with uterine intervention and is typically associated with complications of pregnancy. Retained products of conception (RPOC) are a relatively common cause of EMV. EMV means a tortuous rich vascular network within the myometrium and should have a peak systolic velocity (PSV) of ≥ 20 cm/ sec. There is a growing understanding that the vast majority of EMVs do not actually represent true AVM. It was recommended by ISUOG that “EMV” is the preferred term for what was previously known as an “acquired AVM”. True uterine AVM appear identical on transvaginal color Doppler ultrasound, as well as on CT or MR angiography, and can only be distinguished from EMV on digital subtraction angiography. Spontaneous resolution can occur after 5 weeks (1 week -6 months). Depends on patient’s symptom or desire D&C and embolization can also be used as treatment options.