title: Contralateral decubitus positioning enhances computed tomographic angiographic evaluation of pulmonary vasculature in a patient with a pulmonary arteriovenous malformation.
abstract: Computed tomographic pulmonary angiography has become the diagnostic procedure of choice in patients suspected of having a pulmonary embolus. However, intrapulmonary shunting of blood in a variety of pathologic conditions can cause suboptimal opacification of the pulmonary arterial circulation and result in a suboptimal or even nondiagnostic study. Radiologists should be aware of these conditions and be familiar with positioning techniques to minimize such shunting. We report a patient suspected of having pulmonary embolism, in whom a preexisting unilateral arteriovenous malformation prevented adequate evaluation of the pulmonary circulation. Positioning the patient in the contralateral decubitus position significantly enhanced image quality.
authors.affiliation: Department of Imaging, Veterans Administration-Greater Los Angeles Health Care System, Los Angeles, CA 90073, USA.
authors.forename: Bashir Akhavan
authors.initials: BA
authors.lastname: Tafti
authors.forename: Gholam R
authors.initials: GR
authors.lastname: Berenji
authors.forename: Silverio
authors.initials: S
authors.lastname: Santiago
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Barack
mesh_terms: D000368:Aged; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D056888:Patient Positioning / Q000379:methods*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011652:Pulmonary Circulation; D011655:Pulmonary Embolism; D011856:Radiographic Image Enhancement / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol