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(Radiology. 2001;219:243-246.)
© RSNA, 2001

Thoracic Imaging

Pulmonary Arteriovenous Malformations: Three-dimensional Gadolinium-enhanced MR Angiography—Initial Experience1

Daniel D. Maki, MD, Evan S. Siegelman, MD, David A. Roberts, MD, PhD, Richard A. Baum, MD and Warren B. Gefter, MD

1 From the Department of Radiology, University of Pennsylvania Medical Center, Philadelphia. Received August 9, 1999; revision requested September 27; final revision received September 12, 2000; accepted September 19. Address correspondence to D.D.M., Scottsdale Medical Imaging, 3501 N Scottsdale Rd, Ste 130, Scottsdale, AZ 85251 (e-mail: cactusrad@hotmail.com).

PURPOSE: To determine whether three-dimensional gadolinium-enhanced magnetic resonance (MR) angiography could be used to identify pulmonary arteriovenous malformations (PAVMs) and to accurately identify the size and number of feeding arteries.

MATERIALS AND METHODS: Eight patients suspected of having PAVM were examined with three-dimensional MR angiography at 1.5 T. Images were reviewed by a single radiologist blinded to conventional angiographic findings who evaluated each image for the size, number, and location of PAVMs, as well as for the size and number of feeding arteries. Five patients underwent conventional angiography with embolization therapy, and one patient underwent lobectomy. Two patients did not undergo either surgery or angiography.

RESULTS: Three-dimensional MR angiography revealed nine (90%) of 10 PAVMs that were confirmed at conventional angiography (n = 9) or examination of a surgical specimen (n = 1). The single PAVM that was not identified prospectively at MR angiography was small (3–4 mm) and peripheral. Two additional PAVMs were identified in the two patients who did not undergo surgery or angiography.

CONCLUSION: Three-dimensional MR angiography is a promising technique for use in the diagnosis of PAVM, although small (<5-mm) PAVMs may be more difficult to identify with the technique. The technique is a particularly useful means of noninvasively demonstrating the size and number of feeding arteries prior to treatment.

Index terms: Angiography, 60.1241 • Arteriovenous malformations, pulmonary, 60.1494 • Lung, MR, 60.121411, 60.121412 • Magnetic resonance (MR), vascular studies, 60.121412, 60.12142, 60.12143




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