Document Detail


Digital subtraction pulmonary arteriography versus multidetector CT in the detection of pulmonary arteriovenous malformations.
MedLine Citation:
PMID:  18774307     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare digital subtraction pulmonary arteriography (PA) with 16-detector row computed tomography (CT) in the detection of suspected pulmonary arteriovenous malformations (PAVMs) in patients with hereditary hemorrhagic telangiectasia (HHT). MATERIALS AND METHODS: Eighteen nonconsecutive patients (median age, 47.5 years; range, 26-78 y) with a total of 42 PAVMs were included over a period of 2.75 years. At the authors' institution, all patients with HHT and their family members undergo contrast echocardiography. Positive contrast echocardiography findings prompt multidetector CT (MDCT) scanning, which, in the case of positive findings, is then followed by digital subtraction PA and embolotherapy as appropriate. Catheter-based PA was performed in the study group drawn from the group that underwent MDCT and PA. Evaluation of PAVM presence, location, and type in PA studies was conducted by three blinded interventional radiology physician reviewers and compared with the readings of MDCT studies by three blinded MDCT physician reviewers. Consensus review was performed after blinded readings were complete. RESULTS: Whole-lung analysis (ie, correct identification of a lesion anywhere in the lung) showed MDCT readings to have a mean sensitivity of 83% and specificity of 78% and PA readings to have a mean sensitivity of 70% and specificity of 100%. Lobar analysis (ie, correct identification of a lesion in a given lobe) showed MDCT readings to have a mean sensitivity of 72% and specificity of 93% and PA readings to have a mean sensitivity of 68% and specificity of 100%. CONCLUSIONS: According to the definitions in this study, MDCT provides greater sensitivity in the detection of PAVM than digital subtraction PA, but does so with a loss in specificity, and the differences depend on the level analyzed (ie, lung vs lobe).
Authors:
Asad Nawaz; Harold I Litt; S William Stavropoulos; Sridhar R Charagundla; Richard D Shlansky-Goldberg; David B Freiman; Jesse Chittams; Reed E Pyeritz; Scott O Trerotola
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2008-09-05
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  19     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-28     Completed Date:  2009-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1582-8     Citation Subset:  IM    
Affiliation:
Division of Interventional Radiology, Department of Radiology, University of Pennsylvania Medical Center, 3400 Spruce Street, 1 Silverstein, Philadelphia, Pennsylvania 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography, Digital Subtraction / methods*
Arteriovenous Malformations / radiography*
Female
Humans
Male
Middle Aged
Pulmonary Artery / abnormalities*,  radiography*
Pulmonary Veins / abnormalities*,  radiography*
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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