Multiple pulmonary arteriovenous fistulas demonstrated by dynamic radionuclide pulmonary perfusion scanning.
Dynamic radionuclide perfusion scintigraphy performed with 99mTc-labeled microspheres was instrumental in establishing the diagnosis of multiple, small-vessel, pulmonary arteriovenous fistulas in a 14-month-old patient with cyanosis. Computer analysis of the sequential distribution of tagged microspheres in the pulmonary parenchyma normally demonstrates a curve that rises rapidly to a plateau as the particles microembolize. In the case reported here, the pulmonary flow curve rose rapidly to a maximum and then fell within 2 sec to a plateau of less than 50% of the maximum count, indicating that a large proportion of the microsophers passed through the pulmonary circulation. Conventional pulmonary contrast angiography did not demonstrate any intracardiac shunting but did confirm the presence of multiple pulmonary arteriovenous fistulas.
D001164:Arteriovenous Fistula / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008863:Microspheres; D011651:Pulmonary Artery; D011652:Pulmonary Circulation; D011667:Pulmonary Veins; D013667:Technetium
D013667:Technetium