Diagnosis of arteriovenous malformation of the internal iliac vessels by color Doppler ultrasonography: A case report

A 13-year-old girl was admitted to the hospital because of cardiomegaly found incidentally at regular medical checkup at her school. Although dilated cardiomyopathy was suspected, the girl showed no symptoms. chest x-ray film showed cardiomegaly (cardiothoracic ratio, 67%), and echocardiogram demonstrated a dilatation of the left ventricle without thinning of the wall. While contraction was diffusely decreased, estimated cardiac output was increased to 13l/minute. Abdominal ultrasonography conducted to clarify the cause of this high output showed a multicystic lesion (8×6×4 cm) at the back of the left common iliac artery. Color Doppler ultrasonography revealed abundant blood flow within the lesion, establishing the diagnosis of arteriovenous malformation. Aortography delineated the arteriovenous malformation being supplied from the left internal iliac artery and from the left third and fourth lumbar arteries and drainage into the left common iliac vein and the right internal iliac vein. Although it did not show the precise location of the feeding and draining vessels, color Doppler ultrasonography was useful for the diagnosis of arteriovenous malformation.