title: Utility of contrast echocardiography for pulmonary arteriovenous malformation screening in pediatric hereditary hemorrhagic telangiectasia.
abstract: OBJECTIVE
  To evaluate the utility of transthoracic contrast echocardiography (TTCE) as a screening tool for pulmonary arteriovenous malformations (PAVMs) in children with hereditary hemorrhagic telangiectasia (HHT).
  
  
  METHODS
  This was a single-center study of children who underwent baseline screening for PAVMs using both TTCE and chest computed tomography (CT) for evaluation of HHT. The CT and TTCE results were prospectively reviewed independently by 2 radiologists and 2 cardiologists blinded to the study results.
  
  
  RESULTS
  Both intraobserver and interobserver agreement for interpreting TTCE results were excellent (κ = 0.97 and 0.92, respectively) and higher than the interobserver agreement for CT interpretation (κ = 0.75). The sensitivity and specificity of TTCE to predict PAVMs were 1 and 0.82, respectively, and the positive predictive and negative predictive values were 0.39 and 1, respectively.
  
  
  CONCLUSIONS
  TTCE is a sensitive test for PAVMs in children with suspected HHT and can be a useful initial screening tool in pediatric HHT.
authors.affiliation: Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Suhail
authors.initials: S
authors.lastname: Al-Saleh
authors.forename: Andreea
authors.initials: A
authors.lastname: Dragulescu
authors.forename: David
authors.initials: D
authors.lastname: Manson
authors.forename: Fraser
authors.initials: F
authors.lastname: Golding
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Traubici
authors.forename: Meir
authors.initials: M
authors.lastname: Mei-Zahav
authors.forename: Ian B
authors.initials: IB
authors.lastname: Maclusky
authors.forename: Marie E
authors.initials: ME
authors.lastname: Faughnan
authors.forename: Susan
authors.initials: S
authors.lastname: Carpenter
authors.forename: Felix
authors.initials: F
authors.lastname: Ratjen
mesh_terms: D000293:Adolescent; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media