Vein Diameter on Unenhanced Multidetector CT Predicts Reperfusion of Pulmonary Arteriovenous Malformation after Embolotherapy

Autor: Vincent Cottin, Salim Si-Mohamed, Sophie Gonidec, Loic Boussel, Philippe Douek, Didier Revel, D. Gamondes
Přispěvatelé: Groupe Hospitalier Est, Service de Radiologie, Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Department of Pneumology [Lyon], Infections Virales et Pathologie Comparée - UMR 754 (IVPC), Institut National de la Recherche Agronomique (INRA)-École pratique des hautes études (EPHE)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Department of Radiology, Cardiological Hospital, Hospices Civils de Lyon, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut National de la Recherche Agronomique (INRA)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Rok vydání: 2015
Předmět:
Adult
Male
medicine.medical_specialty
Percutaneous
Adolescent
[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging
medicine.medical_treatment
Pulmonary Artery
030218 nuclear medicine & medical imaging
Arteriovenous Malformations
Young Adult
03 medical and health sciences
0302 clinical medicine
medicine.artery
Multidetector Computed Tomography
medicine
Humans
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Embolization
Child
10. No inequality
Vein
Aged
Retrospective Studies
Neuroradiology
Aged
80 and over
medicine.diagnostic_test
business.industry
Angiography
Interventional radiology
General Medicine
Middle Aged
medicine.disease
Embolization
Therapeutic
3. Good health
Pulmonary embolism
medicine.anatomical_structure
Pulmonary Veins
030220 oncology & carcinogenesis
Pulmonary artery
cardiovascular system
Female
Radiology
Pulmonary Embolism
business
Zdroj: Eur Radiol
Eur Radiol, 2016, 26 (8), pp.2723--2729
ISSN: 1432-1084
0938-7994
Popis: [DOI:\hrefhttps://dx.doi.org/10.1007/s00330-015-4090-810.1007/s00330-015-4090-8] [PubMed:\hrefhttps://www.ncbi.nlm.nih.gov/pubmed/1496318114963181]; 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.\ 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.\ 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 %).\ A diameter of the draining vein of PAVM of 2.5 mm or greater on unenhanced MDCT is a strong predictor of reperfusion.\ • 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 %.
Databáze: OpenAIRE
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