Enhanced Myometrial Vascularity: A New Angiographic Perspective

Monday, March 31, 2025

5:20 PM – 5:25 PM CT

Location: Music City Center, 207 CD

Abstract Presenter(s)

Brendan Carney, DO (he/him/his)

Resident
University of Iowa Hospitals and Clinics, United States

Author/Co-author(s)

MA

Mohammed AbuBakar, BA

Medical Student
Kansas City University, United States
MC

Maria Gabriela Cintra Borba, MD

Resident
Instituto de Assistência ao Servidor Público Estadual de São Paulo (IAMSPE), Brazil
GA

Gustavo Andrade, MD, PhD

Visiting Associate Professor of Radiology
University of Iowa Hospitals and Clinics, United States
VF

Vinicius Fornazari, MD, PhD

Interventional Radiologist
UNIFESP - Federal University of Sao Paulo, Brazil

Learning Objectives:

Understand the concept of enhanced myometrial vascularity (EMV) and its relevance in gynecological imaging.

Differentiate EMV from uterine arteriovenous malformations (AVMs).

Review the imaging and angiographic findings used to diagnose EMV.

Discuss the interventional radiology management of EMV.

Background: Enhanced myometrial vascularity (EMV) is an emerging angiographic finding often mistaken for uterine arteriovenous malformations (AVMs). AVMs are congenital abnormalities characterized by dilated, tangled vessels with turbulent high-flow, but true uterine AVMs are extremely rare. Recently, EMV has been identified as an acquired vascular pattern typically occurring in the context of recent pregnancy or abortion. While EMV presents with similar imaging features to AVMs—such as low-resistance, high-flow vessels—the underlying pathology and management differ significantly.

Clinical Findings/Procedure Details:

Based on clinical history and imaging findings, EMV and uterine AVMs can be differentiated. Angiographic findings of EMV reveal an abnormal network of dilated myometrial vessels, mimicking uterine AVMs. In contrast, uterine AVMs will show a network of dilated, draining veins. The cases shown will highlight the interventional radiologist's role in identifying and treating EMV using uterine artery embolization.

Conclusion and/or Teaching Points: Enhanced myometrial vascularity is a newly recognized angiographic finding that closely mimics uterine AVMs, but differs in its etiology, typically associated with recent pregnancy or abortion. Proper diagnosis is essential for guiding treatment. This exhibit provides essential teaching points, including a case-based analysis, and technical considerations for catheter embolization in EMV cases. By recognizing and differentiating these unique vascular patterns, interventional radiologists can refine their treatment strategies and improve patient outcomes.