The value of ultrasound parameters in predicting treatment modalities for uterine arteriovenous malformations

Objective To analyze the predictive value of ultrasound parameters in selecting clinical treatment options for patients with uterine arteriovenous malformation (AVM). Methods Data and ultrasound parameters of patients with clinically diagnosed uterine AVM who attended the 900TH Hospital of the Joint Logistic Support Force from January 2015 to December 2023 were collected retrospectively. According to the difference in clinical treatment protocols, the differences in lesion length and ultrasound parameters such as PSV, EDV, PI, and RI were analyzed in the expectant observation group, the drug treatment group, and the UAE treatment group. All patients were also divided into UAE-treated and non-UAE-treated groups according to whether or not uterine artery embolization (UAE) was performed, and effective indicators that could predict the need for embolization for hemostasis were screened, and their predictive efficacy was judged by the univariate and multiple logistic regression analyses and plotting the working characteristic curves (ROCs) of the subjects. Results For patients with different treatment protocols, it was found that the mean PSV and EDV values were higher in cases with UAE hemostasis than those with pharmacological hemostasis and expectant treatment (P < 0.001); the mean PSV and EDV values were higher in cases with pharmacological hemostasis than those with expectant treatment (P < 0.001); and there was no significant difference in the values of lesion length, PI, and RI (P > 0.05). After univariate and multiple logistic regression analyses, it was shown that peak systolic blood flow velocity (PSV) was a significantly effective predictor of the need for UAE hemostasis (P < 0.001), with higher PSV being associated with a higher probability of needing UAE hemostasis. For every 1 cm/s increase in prediction, the likelihood of using UAE for hemostasis increased by 0.065. In addition, the highest accuracy in distinguishing the need for UAE for hemostasis was achieved when the PSV was 61.50 cm/s, with a sensitivity of 72.70%, a specificity of 96.90%, and an AUC of 0.818. Conclusion Blood flow parameters of ultrasound are valuable in the selection of treatment options for uterine AVM. We found that the mean PSV and EDV values of patients with UAE hemostasis were higher than those treated with non-UAE, and PSV was a significantly effective predictor of the need for UAE hemostasis.