Pulmonary arteriovenous malformations: evaluation with CT of the chest before and after treatment.

Abstract

A total of 109 single or multiple pulmonary arteriovenous malformations (PAVMs) were evaluated with computed tomography (CT) of the chest in 40 patients separated into three groups to study the usefulness of CT (a) in the diagnosis and pretherapeutic management of PAVMs by comparison with selective pulmonary angiography of each lung (group 1: 20 patients), (b) in the follow-up of patients who received treatment (group 2: 27 patients), and (c) as an isolated diagnostic procedure in elderly patients (n = 3) or family members with Osler-Weber-Rendu disease (n = 8) (group 3: 11 patients). Follow-up ranged from several weeks to 10 years (mean follow-up, 4 years). In group 1, conventional and dynamic CT enabled identification of 107 PAVMs (98.2%) (vs 65 PAVMs [59.6%] identified with angiography), with confident segmental location in 56 of 65 PAVMs (86%) and reliable analysis of angioarchitecture in 17 PAVMs (26%) (vs 39 PAVMs [60%] analyzed with angiography). In group 2, progressive aneurysmal retraction was associated with successful occlusion. In group 3, CT enabled noninvasive evaluation of patients unable to undergo treatment and detection of PAVMS in family members.