Diagnosis of pregnancy-associated uterine venous plexus thrombosis on the basis of transvaginal sonography.

OBJECTIVE: To describe the sonographic signs of uterine venous plexus thrombosis. METHODS: Four pregnant patients had a diagnosis of uterine venous plexus thrombosis in the first half of gestation. The diagnosis was based on transvaginal sonography only in 3 cases, and the fourth had magnetic resonance imaging corroboration. RESULTS: All 4 patients had similar sonographic features of uterine venous plexus thrombosis on transvaginal sonographic examination. The thrombi within the dilated veins were shown as elongated echogenic structures along the lumen that appeared round on transverse views of the affected veins. They showed swinging movements provoked by gentle transducer pressure. Power and color Doppler sonography enhanced the uterine venous plexus thrombosis diagnosis by showing blood flow around the thrombi. There were no signs of thromboembolic disease. Sonographic findings in deep leg veins and iliac veins were normal in all cases. Complete thrombophilia studies did not reveal any abnormalities. The uterine venous plexus thrombosis could not be detected on transabdominal sonography and was shown better by transvaginal sonography compared with magnetic resonance imaging. During 3 months of anticoagulation therapy, the thrombi gradually disappeared in all cases. CONCLUSIONS: Focusing on the pelvic veins while performing a transvaginal sonographic study during pregnancy may reveal important findings, which may have clinical implications. The therapeutic treatment of uterine venous plexus thrombosis is controversial and still empirical.

Clinical spectrum of asymptomatic femoral neck abnormal uptake on bone scintigraphy.

UNLABELLED: The purpose of this study was to assess the clinical spectrum of asymptomatic abnormal focal uptake of (99m)Tc-methylene diphosphonate (MDP) in the femoral neck. METHODS: Fifteen consecutive patients with asymptomatic abnormal focal uptake of (99m)Tc-MDP in the femoral neck were evaluated. Two patients had bilateral abnormal focal uptake. The patient's history, clinical findings, and plain hip radiograph were obtained in all cases. Scintigraphic, radiographic and clinical findings were correlated. RESULTS: Eight of 17 (47%) femoral necks showed a definite herniation pit on radiography, 6 patients (35%) had normal radiographic findings, 1 patient had a bone island, 1 patient had a bone island and a herniation pit, and 1 patient had a subtle lesion suggestive of a herniation pit on radiography. All patients remained asymptomatic for at least a 10-mo follow-up period. CONCLUSION: A herniation pit is the most common finding among asymptomatic abnormal femoral neck focal uptake. This condition should be distinguished from a wide variety of disorders associated with increased focal abnormal uptake of (99m)Tc-MDP in the femoral neck.