Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 16 , ISSUE 4 ( October-December, 2022 ) > List of Articles


Imaging of Acquired Uterine Lesions

Zorancho Petanovski, Asim Kurjak, Emilija Petanovska Kostova

Keywords : Color Doppler sonography, Enhanced myometrial vascularity/arteriovenous malformation, Intrauterine adhesions (Asherman's syndrome), Nabothian cysts, The isthmocele, Transvaginal ultrasound, Three-dimensional ultrasonography

Citation Information : Petanovski Z, Kurjak A, Kostova EP. Imaging of Acquired Uterine Lesions. Donald School J Ultrasound Obstet Gynecol 2022; 16 (4):298-303.

DOI: 10.5005/jp-journals-10009-1946

License: CC BY-NC 4.0

Published Online: 26-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


In general, the group of acquired uterine lesions consists of enhanced myometrial vascularity (EMV)/arteriovenous malformation (AVM), the isthmocele, intrauterine adhesions (IUAs) (Asherman's syndrome), and nabothian cysts. Uterine AVMs can be congenital or acquired. These vascular lesions can cause severe hemorrhage that can be life-threatening for a woman, so it has been recently suggested that curettage should not be performed in a patient who presents with abnormal uterine bleeding after an abortion or a delivery when there is an ultrasound-detected hypervascular area with turbulent flow within the myometrium. Color Doppler sonography is the preferred method of diagnosing uterine EMV/AVMs. The isthmocele is a myometrial defect resembling a pouch on the anterior wall of the uterine isthmus over a previous cesarean scar. Transvaginal ultrasound (TVUS) is the initial and most usual method described to assess the integrity of the uterus wall in nonpregnant patients. IUAs are also known as intrauterine synechiae or endometrial sclerosis. The most common presentation of Asherman's syndrome is secondary infertility. Two-dimensional (2D)/three-dimensional (3D) TVUS is useful in measuring the thickness of the endometrial lining. Also, together with or without sonohysterography (injection of sterile saline into the uterine cavity) can show the adhesions that characteristically appear as “bridging bands” of tissue that distort the cavity. Nabothian cysts are a common occurrence on the cervix. These are retention cysts of the endocervical glands caused by chronic inflammation. 3D ultrasonography gives an excellent image and the possibility of detecting nabothian cysts.

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