Type:
Educational Exhibit
Keywords:
Lung, Pulmonary vessels, Vascular, CT-Angiography, CT, Surgery, Arterial access, Angioscopy, Arteriovenous malformations
Authors:
I. Koroleva, V. Parshin, M. Mishchenko; Moscow/RU
DOI:
10.26044/ecr2019/C-0527
Background
Pulmonary arteriovenous malformations is a pathological connection between the arterial and venous systems,
as a results in direct bypass of non-oxygenated blood into the left atrium bypassing the capillary pulmonary system.
Malformation leads can cause embolism of the systemic circulation,
and cause pulmonary bleeding [1,2,3].
At present,
PAVM has become one of the fields of application of X-ray endovascular surgical techniques [4,5].
PAVM can be suspected on chest radiographs.
They are characterized by the presence of pathological shadows localized mainly in the peripheral parts of lower lobes of the lungs.
MDCT
with intravenous contrast enhancement is the most valuable diagnostic method,
which allows to establish PAVM,
determine the number and anatomical characteristics of pulmonary vessels involved in the pathological process,
which is extremely important for defining end-endovascular tactics interventions,
choice of method and material of occlusion.
CT signs: PAVM looks like round or oval,
well-contoured formations (seals) with a diameter of several millimeters to several centimeters.
May contain calcifications.
In intravenous contrasting formations have intense contrast enhancement (synchronous with contrasting pulmonary arteries) in which dilated convoluted blood vessels are visualized.
Magnetic resonance imaging in the diagnosis of PAVM is not widely used (artifacts from respiratory movements,
the duration of the procedure) and today can not replace the spiral computed tomography.
Angiography - allows to determine the number,
size and diameter of the pulmonary arteries involved in the process,
measure the pressure in the pulmonary artery and explore the gas composition of the blood of a particular department of the pulmonary circulation.