Angioarchitecture of pulmonary arteriovenous malformations: clinical utility of three-dimensional helical CT.

Abstract

To determine the clinical utility of three-dimensional (3D) helical computed tomography (CT) in pretherapy evaluation of the angioarchitecture of pulmonary arteriovenous malformations (PAVMs). Thirty-seven PAVMs were prospectively evaluated with both helical CT and pulmonary angiography. Single-threshold shaded-surface displays were obtained with 2- or 5-mm section thickness, a pitch of 1, and a 360 degrees linear interpolation algorithm but without injection of contrast medium. A reliable analysis of the angioarchitecture of 28 PAVMs (76%)--25 simple and three complex--was provided by 3D reconstructions; combined interpretation of 3D images and transverse sections led to accurate evaluation of 35 PAVMs (95%). Positioning of the target anatomy in the reconstructed volume, threshold value, number of stacked sections, and section thickness influenced the diagnostic information. Unenhanced 3D helical CT appears to be a reliable noninvasive tool for pretherapy evaluation of PAVMs.