title: Vein Diameter on Unenhanced Multidetector CT Predicts Reperfusion of Pulmonary Arteriovenous Malformation after Embolotherapy.
abstract: OBJECTIVE
  To evaluate the value of the diameter of the draining vein of pulmonary arteriovenous malformation (PAVM) on unenhanced chest MDCT in diagnosing reperfusion after percutaneous vaso-occlusion therapy.
  
  
  METHODS
  We retrospectively reviewed our long-term experience of patients with hereditary haemorrhagic telangiectasia and selected cases on the following criteria: an initial pulmonary angiogram with embolotherapy of at least one PAVM, a follow-up MDCT examination in the following year followed by a second pulmonary angiogram with embolotherapy if needed. Follow-up unenhanced chest MDCT examinations were analyzed blindly from results of pulmonary artery angiogram and clinical data, the diameter of the efferent vein close to the PAVM sac was measured, then compared to those of pulmonary artery angiogram as a gold standard.
  
  
  RESULTS
  Eighty-eight of 100 patients met inclusion criteria, in whom 62 of 176 PAVMs were reperfused at angiogram. The mean diameter of the efferent vein on MDCT was 4.3 ± 2.1 mm in patent PAVMs and 1.8 ± 0.9 mm in non-patent PAVMs (p < 0.0001). The optimal cutoff diameter based on ROC analysis was 2.5 mm (sensitivity = 98.4 %; specificity = 87.7 %).
  
  
  CONCLUSIONS
  A diameter of the draining vein of PAVM of 2.5 mm or greater on unenhanced MDCT is a strong predictor of reperfusion.
  
  
  CONCLUSIONS
  • Diameter of draining vein of 2.5 mm or greater is associated with reperfusion. • Unenhanced chest MDCT predicts reperfusion of PAVMs with good sensitivity and specificity. • Unenhanced MDCT can guide a decision of repeat pulmonary angiogram and embolotherapy. • The mean vein diameter change of PAVMs occluded at follow-up is 3.8 mm. • Overall success rate after a median of 6 months embolotherapy was 64.7 %.
authors.affiliation: Department of Thoracic and Cardiac Imaging, Louis Pradel Hospital, University of Lyon 1, 28 avenue Doyen Lépine, F-69677, Lyon (Bron) Cedex, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Gamondès
authors.affiliation: Department of Thoracic and Cardiac Imaging, Louis Pradel Hospital, University of Lyon 1, 28 avenue Doyen Lépine, F-69677, Lyon (Bron) Cedex, France. salim_sidi@hotmail.com.
authors.forename: Salim
authors.initials: S
authors.lastname: Si-Mohamed
authors.affiliation: National reference Center for rare pulmonary diseases, Louis Pradel Hospital, University of Lyon 1, Lyon, France.|Reference Center for Hereditary Hemorrhagic Telangiectasia, Groupe Hospitalier Est, Lyon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Cottin
authors.affiliation: Department of Thoracic and Cardiac Imaging, Louis Pradel Hospital, University of Lyon 1, 28 avenue Doyen Lépine, F-69677, Lyon (Bron) Cedex, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Gonidec
authors.affiliation: Department of Thoracic and Cardiac Imaging, Louis Pradel Hospital, University of Lyon 1, 28 avenue Doyen Lépine, F-69677, Lyon (Bron) Cedex, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Boussel
authors.affiliation: Department of Thoracic and Cardiac Imaging, Louis Pradel Hospital, University of Lyon 1, 28 avenue Doyen Lépine, F-69677, Lyon (Bron) Cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Douek
authors.affiliation: Department of Thoracic and Cardiac Imaging, Louis Pradel Hospital, University of Lyon 1, 28 avenue Doyen Lépine, F-69677, Lyon (Bron) Cedex, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Revel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D001165:Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis*; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011667:Pulmonary Veins / Q000002:abnormalities / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Embolization; Hereditary hemorrhagic telangiectasia; Multidetector CT; Osler-Rendu-Weber disease; Pulmonary arteriovenous malformations