| Digital subtraction pulmonary arteriography versus multidetector CT in the detection of pulmonary arteriovenous malformations. | |
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MedLine Citation:
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PMID: 18774307 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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). |
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Authors:
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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:
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Type: Comparative Study; Evaluation Studies; Journal Article Date: 2008-09-05 |
Journal Detail:
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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:
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Created Date: 2008-10-28 Completed Date: 2009-01-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 1582-8 Citation Subset: IM |
Affiliation:
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Division of Interventional Radiology, Department of Radiology, University of Pennsylvania Medical Center, 3400 Spruce Street, 1 Silverstein, Philadelphia, Pennsylvania 19104, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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