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2014 | 10 | 1 |

Article title

Carotid ultrasound for pulmonary arteriovenous malformation screening


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Objective: In patients with hereditary hemorrhagic
telangiectasia (HHT), pulmonary arteriovenous
malformations (PAVMs) can cause serious neurological
complications. Our aim was to evaluate the potential of
contrast-enhanced Doppler ultrasound (CE-US) of the
common carotid artery as a screening test for detection
of PAVMs. Methods: A total of 124 consecutive patients
with HHT or a positive family history underwent screening
for PAVMs with CE-US and thoracic contrast-enhanced
magnetic resonance angiography (CE-MRA). CE-US was
performed after receiving (D)-galactose microparticulate,
and CE-MRA with gadobenate dimeglumine. Twenty-five
patients with confirmed PAVMs were referred to conventional
pulmonary catheter angiography (PA). Findings
on CE-US and CE-MRA were evaluated using contingency
tables and McNemar’s test. Results: Using CE-MRA as the
reference test, CE-US had a sensitivity of 100%, a specificity
of 87%, and a negative predictive value of 100%.
In 25 patients who underwent PA, PAVMs that had been
diagnosed on CE-US and CE-MRA were confirmed. Of the
PAVMs detected by CE-MRA, 24% were not identified on
PA. Conclusion: CE-US is a simple, minimally invasive
screening method that can easily be performed in different settings. CE-US can predict PAVMs with high probability
of success. CE-US may be a simple alternative to transthoracic
echocardiography in the assessment of PAVMs in
certain HHT-patients.








Physical description


11 - 5 - 2015
19 - 12 - 2014
4 - 4 - 2015


  • Department of Cardiology,
    Städtisches Krankenhaus Pirmasens gGmbH, Pettenkoferstr.
    22, 66955 Pirmasens, Germany
  • Medical Faculty of the Saarland University,
    66421 Homburg/Saar, Germany
  • Department of Diagnostic and Interventional
    Radiology, Saarland University Hospital, 66421 Homburg/Saar,
  • Department of Diagnostic and Interventional
    Radiology, Saarland University Hospital, 66421 Homburg/Saar,
  • Department of Medical Biometry, Epidemiology and
    Medical Informatics, Saarland University Hospital, 66421 Homburg/
    Saar, Germany
  • Department of Otorhinolaryngology, Essen
    University Hospital, 45147 Essen, Germany


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