Pulmonary arteriovenous malformations: Three-dimensional gadolinium-enhanced MR angiography - Initial experience

PURPOSE: To determine whether three-dimensional gadolinium-enhanced magneti c resonance (MR) angiography could be used to identify pulmonary arterioven ous malformations (PAVMs) and to accurately identify the size and number of feeding arteries. MATERIALS AND METHODS: Eight patients suspected of having PAVM were examine d with three-dimensional MR angiography at 1.5 T. Images were reviewed by a single radiologist blinded to conventional angiographic findings who evalu ated each image for the size, number, and location of PAVMs, as well as for the size and number of feeding arteries. Five patients underwent conventio nal angiography with embolization therapy, and one patient underwent lobect omy. Two patients did not undergo either surgery or angiography. RESULTS: Three-dimensional MR angiography revealed nine (90%) of 10 PAVMs t hat were confirmed at conventional angiography (n = 9) or examination of a surgical specimen (n = 1). The single PAVM that was not identified prospect ively at MR angiography was small (3-4 mm) and peripheral. Two additional P AVMs were identified in the two patients who did not undergo surgery or ang iography. CONCLUSION: Three-dimensienal MR angiography is a promising technique for u se in the diagnosis of PAVM, although small (<5-mm) PAVMs may be more diffi cult to identify with the technique. The technique is a particularly useful means of noninvasively demonstrating the size and number of feeding arteri es prior to treatment.