3D Doppler territorial vascular mapping as a prognostic tool in uterine EMV/AVM

IF 1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses Pub Date : 2026-04-01 Epub Date: 2026-02-24 DOI:10.1016/j.mehy.2026.111927

Amin Abolhasani Foroughi , Seyed Sina Dehghani

{"title":"3D Doppler territorial vascular mapping as a prognostic tool in uterine EMV/AVM","authors":"Amin Abolhasani Foroughi , Seyed Sina Dehghani","doi":"10.1016/j.mehy.2026.111927","DOIUrl":null,"url":null,"abstract":"<div><div>Acquired Uterine Enhanced Myometrial Vascularity/Arteriovenous Malformation (EMV/AVM) is uncommon vascular abnormality that can occasionally lead to severe uterine bleeding. Current Doppler indices, such as peak systolic velocity and resistance index, have limited prognostic value. We suggest that assessment of the territorial vascular supply pattern, characterized by involvement of one or multiple uterine regions (anterior, posterior, right lateral, left lateral, and fundal), using three-dimensional (3D) Doppler imaging may serve as a prognostic indicator in the management of these patients. Complex vascular architecture with multiple feeding arteries or overlapping territories may predict persistent hemorrhage and a higher need for embolization, whereas single-territory involvement may indicate a greater chance of spontaneous regression. Incorporating 3D Doppler into diagnostic protocols could refine risk stratification, reduce unnecessary interventions, and ultimately improve reproductive outcomes. This hypothesis calls for observational studies integrating vascular territory mapping alongside current Doppler parameters to establish its predictive role in acquired EMV/AVM.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"209 ","pages":"Article 111927"},"PeriodicalIF":1.0000,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical hypotheses","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0306987726000563","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}

引用次数: 0

Abstract

Acquired Uterine Enhanced Myometrial Vascularity/Arteriovenous Malformation (EMV/AVM) is uncommon vascular abnormality that can occasionally lead to severe uterine bleeding. Current Doppler indices, such as peak systolic velocity and resistance index, have limited prognostic value. We suggest that assessment of the territorial vascular supply pattern, characterized by involvement of one or multiple uterine regions (anterior, posterior, right lateral, left lateral, and fundal), using three-dimensional (3D) Doppler imaging may serve as a prognostic indicator in the management of these patients. Complex vascular architecture with multiple feeding arteries or overlapping territories may predict persistent hemorrhage and a higher need for embolization, whereas single-territory involvement may indicate a greater chance of spontaneous regression. Incorporating 3D Doppler into diagnostic protocols could refine risk stratification, reduce unnecessary interventions, and ultimately improve reproductive outcomes. This hypothesis calls for observational studies integrating vascular territory mapping alongside current Doppler parameters to establish its predictive role in acquired EMV/AVM.

查看原文本刊更多论文

三维多普勒定位作为子宫EMV/AVM的预后工具

获得性子宫肌层血管增强/动静脉畸形（EMV/AVM）是一种罕见的血管异常，偶尔会导致严重的子宫出血。目前的多普勒指标，如峰值收缩速度和阻力指数，对预后的价值有限。我们建议使用三维（3D）多普勒成像评估以累及一个或多个子宫区域（前、后、右侧、左侧和子宫底）为特征的领土血管供应模式，可作为这些患者治疗的预后指标。有多个供血动脉或重叠区域的复杂血管结构可能预示持续出血和更高的栓塞需求，而单一区域的累及可能表明更大的自发性消退机会。将3D多普勒纳入诊断方案可以细化风险分层，减少不必要的干预，最终改善生殖结果。这一假设需要观察性研究，结合血管区域测绘和当前多普勒参数，以确定其在获得性EMV/AVM中的预测作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Medical hypotheses 医学-医学：研究与实验

CiteScore

10.60

自引率

2.10%

发文量

167

审稿时长

60 days

期刊介绍： Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. The Aims and Scope of Medical Hypotheses are no different now from what was proposed by the founder of the journal, the late Dr David Horrobin. In his introduction to the first issue of the Journal, he asks ''what sorts of papers will be published in Medical Hypotheses? and goes on to answer ''Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary''. (Horrobin DF, 1975 Ideas in Biomedical Science: Reasons for the foundation of Medical Hypotheses. Medical Hypotheses Volume 1, Issue 1, January-February 1975, Pages 1-2.). Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations.