title: Utility of MDCT MIP Postprocessing Reconstruction Images in Children With Hereditary Hemorrhagic Telangiectasia.
abstract: OBJECTIVE
  The aim of the study was to evaluate whether maximum intensity projection (MIP) images improve the detection and the delineation of the anatomic makeup of pulmonary nodules and/or arteriovenous malformations (pAVMs) in children with hereditary hemorrhagic telangiectasia (HHT).
  
  
  METHODS
  Two radiologists (D.M., E.I.C.) performed a blinded review of chest multidetector computed tomography scans in 39 children (age, 0-18 years) with proven HHT. Multiplanar 2.5 mm slices were blindly compared with multiplanar MIP for the presence of nodules and/or overt pAVMs and for the ability to identify vessels associated with the pAVMs. Parameters that were assessed included number of definitive nodules, number of definitive pAVMs, and the ability to detect the feeding artery or draining vein in both conventional and MIP images.
  
  
  RESULTS
  Our study showed similar detection rates between axial scans and MIP images for the detection of nodules (axial R1: 75 vs 62, P = 0.05; MIPS: 78 vs 86, P = 0.05) and in the determination of definite pAVMS (axials: 21 vs 29, P = 0.0007; MIPS: 27 vs 35, P = 0.01). Statistically significant differences were obtained in the ability to identify the feeding artery and draining vein between standard 2.5 mm slices and MIP images (axials: 13 vs 13, P = 0.0008; MIPS: 27 vs 23, P = 0.01). No other data parameters achieved statistically significance.
  
  
  CONCLUSIONS
  Maximum intensity projection images in children with HHT can help identify the presence and the anatomy of pAVMs for future embolization.
authors.affiliation: From *The Department of Diagnostic Imaging, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain; †Chest Division, The Department of Pediatrics, The Hospital for Sick Children; ‡The Department of Diagnostic Imaging, The Hospital for Sick Children; and §The Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Emilio J
authors.initials: EJ
authors.lastname: Inarejos Clemente
authors.forename: Felix
authors.initials: F
authors.lastname: Ratjen
authors.forename: David E
authors.initials: DE
authors.lastname: Manson
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D061330:Multidetector Computed Tomography; D015588:Observer Variation; D010363:Pattern Recognition, Automated; D011856:Radiographic Image Enhancement; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000000981:diagnostic imaging*