Like other CT techniques, CTPA offers high special resolution and can detect the number, size, and distribution of PAVMs accurately. CTPA provides similar diagnostic accuracy as noncontrast CT due to the high natural contrast inherent to pulmonary anatomy. IV contrast material administration adds a small risk of air embolism in patients with PAVM. Adequate precaution should be taken to prevent air [27]. Correlating the PAVM grade with contrast-enhanced echo has been shown to be more sensitive with CTPA compared to noncontrast CT [31]. Cross-sectional anatomy displayed on CT chest with IV contrast is useful in treatment planning [10,27]. MRA Chest Without and With IV Contrast There is no role for the routine use of MRA chest without and with IV contrast in the workup of a patient suspected of a PAVM. MRA Chest Without IV Contrast There is no role for the routine use of MRA chest without IV contrast in the workup of a patient suspected of a PAVM. MRA Pulmonary Arteries Without and With IV Contrast Contrast-enhanced MRA pulmonary arteries provides anatomical information about the presence, number, size, and location of PAVMs. Schneider et al [32] evaluated 203 patients with HHT or first-degree relatives with HHT using contrast-enhanced MRA. Patients with definite and uncertain diagnosis of PAVM on MRA underwent pulmonary angiogram. Pulmonary angiogram detected only 77% to 80% of the PAVMs that were seen on MRA. In their study, the majority of the PAVMs not detected by pulmonary angiogram were <5 mm in size. The size criterion was defined as the size of the PAVM itself and not of the feeding artery. A more recent study by Van den Heuvel et al Pulmonary Arteriovenous Malformation (PAVM) [33] investigated the sensitivity of contrast-enhanced MRA for detection of PAVMs with a feeding artery >2 cm in children and young adults.
Pulmonary Arteriovenous Malformation PAVM . Like other CT techniques, CTPA offers high special resolution and can detect the number, size, and distribution of PAVMs accurately. CTPA provides similar diagnostic accuracy as noncontrast CT due to the high natural contrast inherent to pulmonary anatomy. IV contrast material administration adds a small risk of air embolism in patients with PAVM. Adequate precaution should be taken to prevent air [27]. Correlating the PAVM grade with contrast-enhanced echo has been shown to be more sensitive with CTPA compared to noncontrast CT [31]. Cross-sectional anatomy displayed on CT chest with IV contrast is useful in treatment planning [10,27]. MRA Chest Without and With IV Contrast There is no role for the routine use of MRA chest without and with IV contrast in the workup of a patient suspected of a PAVM. MRA Chest Without IV Contrast There is no role for the routine use of MRA chest without IV contrast in the workup of a patient suspected of a PAVM. MRA Pulmonary Arteries Without and With IV Contrast Contrast-enhanced MRA pulmonary arteries provides anatomical information about the presence, number, size, and location of PAVMs. Schneider et al [32] evaluated 203 patients with HHT or first-degree relatives with HHT using contrast-enhanced MRA. Patients with definite and uncertain diagnosis of PAVM on MRA underwent pulmonary angiogram. Pulmonary angiogram detected only 77% to 80% of the PAVMs that were seen on MRA. In their study, the majority of the PAVMs not detected by pulmonary angiogram were <5 mm in size. The size criterion was defined as the size of the PAVM itself and not of the feeding artery. A more recent study by Van den Heuvel et al Pulmonary Arteriovenous Malformation (PAVM) [33] investigated the sensitivity of contrast-enhanced MRA for detection of PAVMs with a feeding artery >2 cm in children and young adults.