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- W2335163755 abstract "The purpose of this exhibit is to discuss the US findings of UAVM and it’s mimics. We will examine three cases; Retained products of conception (RPOC), Placenta Accreta, and Gestational Trophoblastic Disease(GTD). A review of radiology literature was performed using the following terms: UAVM, RPOC, Placenta Accreta, and GTD. Initial and follow-up imaging studies were obtained. US findings and treatment options are as follows: A UAVM presents with multiple, tubular, anechoic spaces within myometrium resulting in a “spongy” echotecture. Color Doppler shows mosaic color pattern within myometrial cystic spaces with aliasing associated with high velocity flow. Pulse doppler shows low resistance, high velocity flow within abnormal areas of myometrium.Treatment includes transcatheter arterial embolization, hysterectomy, or a course of medical therapy if stable. GTD will show a cystic intrauterine mass and hydropic placenta on US. Marked vascularity on color doppler with high velocity, low impedence flow and a mean resistive index of 0.55.Treatment includes suction evacuation of the mass and curettage of the myometrium with f/u HCG levels for 1 year. Chemotherapy for invasive disease. RPOC will show heterogenous echogenic material in the endometrial cavity with blood flow on US. Increased blood flow can be seen within the retained tissue and in diffuse areas of myometrium. Small areas of RPOC may pass spontaneously.Larger areas frequently require D&C. Placenta Accreta will show placental vascular lacunae (parallel, linear vascular channels extending from the placental parenchyma into the myometrium). The myometrium is usually thin. Conservative management with uterine preservation is performed if preservation of fertility is desired. If undiagnosed, emergent hysterectomy may need to be performed. Because the clinical presentation and imaging features of many obstetric pathologies often mimic AVM, a correct diagnosis is essential to guide proper management. Physical exam, laboratory values (B-HCG is especially important in both the gestational and post-partum period), ultrasonagraphy, as well as MRI (as a problem solving tool) may help differentiate these different entities." @default.
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- W2335163755 date "2015-04-01" @default.
- W2335163755 modified "2023-09-27" @default.
- W2335163755 title "2079071 Uterine Vascular Abnormalities: Uterine Arteriovenous Malformations & Its Mimics" @default.
- W2335163755 doi "https://doi.org/10.1016/j.ultrasmedbio.2014.12.487" @default.
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