Myometrial cysts for DD

Myometrial cysts for DD.

___ Case (1) : Uterine AVM

.

_ History of :

Gynecologic intervention esp. D&C.

Bleeding usually significant.

With -ve B-hcg.

.

__ DD :

  • Gestational trophoblastic neoplasia (GTN).

_ It has similar doppler findings :
Color Aliasing due to high flow velocities and
Low resistance arterial pattern due to neovascularization.

_ With +ve B-hcg (shooting numbers).

.

___ Other LESS likely DD :

  • RPOC has same doppler but endometrial in location.
    With +ve B-hcg.

  • Adenomyosis has same grey scale appearance but fewer vessels with lower velocities causing dark color - NO aliasing.

  • Cystic changes with myoma but again lower vascularity and should have definable wall - NO aliasing.

  • Congested uterine veins should be symmetric distribution and dark color venous Not arterial flow - NO aliasing.