Contrast-enhanced MR perfusion imaging and MR angiography: utility for management of pulmonary arteriovenous malformations for embolotherapy |
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| Affiliation: | 1. Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan;2. Department of Radiology, Pulmonary Functional Imaging Research, University of Pennsylvania Medical Center, 3600 Market Street, Suite 370, Philadelphia, PA 19104-2649, USA;3. Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan;1. University of Colorado, Children''s Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045, USA;2. Children''s Spine Study Group, P.O. Box 397, Valley Forge, PA 19481, USA;3. Children''s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA;4. Primary Children''s Medical Center, 100 North Mario Capecchi Drive, Salt Lake City, UT 84113, USA;5. University of Tennessee, Campbell Clinic, 1211 Union Avenue, Memphis, TN 38104, USA;6. Shriners Hospital for Children, 3551 North Broad Street, Philadelphia, PA 19140, USA;7. Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA;8. The Children''s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA;9. IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada;10. Children''s Hospital of New York, 3959 Broadway, New York, NY 10032, USA;1. Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo (Fg), Italy;2. Operative Unit of Maxillo-Facial Surgery, Federico II University, Naples, Italy;1. Yunnan Institute of Materia Medica, Kunming 650111, China;2. Innovation and R&D Center, Yunnan Bai Yao Group, Kunming 650111, China;3. Yunnan Province Company Key Laboratory for TCM and Ethnic Drug of New Drug Creation, Kunming 650111, China;1. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;2. Department of Pediatric Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;1. Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistr. 15, 81377 Munich, Germany;2. Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Marchioninistr. 15, 81377 Munich, Germany;3. European Cyberknife Center Munich, 81377 Munich, Germany;4. Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA;1. Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA;2. Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA;3. Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA |
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| Abstract: | Objective: The purpose of this study was to assess the capability of MR perfusion imaging and angiography (MRA) for management of pulmonary arteriovenous malformation (PAVM). Methods and patients: Eight patients, having 15 PAVMs underwent pulmonary angiography (PAG), CT, MR perfusion imaging and MRA. For the pretherapeutic management, MRA was compared with PAG and CT regarding detectability and diameter of vasculature. For post-therapeutic management, the change in size of aneurysmal sac, any residual contrast-enhancement and the blood supply within the sac were evaluated. Results: All PAVMs with aneurysmal sac, feeding artery and draining vein diameters of equal to or more than 3 mm, were identified and measured with similar results by all modalities. On follow-up studies, 7 (58.4%) out of 12 treated PAVMs showed a decrease in size and residual contrast-enhancement. The residual contrast-enhancement was considered as bronchial artery-to-pulmonary artery collateral flow by MR perfusion imaging. Conclusion: MR perfusion imaging and MRangiography are useful for management of PAVMs over 3 mm in diameter. |
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