Carotid ultrasound for pulmonary arteriovenous malformation screening

• Authors: Anita Yanna-Schulze , Günther Schneider , Alexander Maßmann , Stefan Gräber , Urban W. Geisthoff
• Languages of publication: EN

Abstracts

EN

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.

Keywords

EN

Hereditary hemorrhagic telangiectasia; pulmonaryarteriovenous malformation; screening; contrast-enhancedultrasound

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2014
• Volume: 10
• Issue: 1

Dates

online

11 - 5 - 2015

received

19 - 12 - 2014

accepted

4 - 4 - 2015

Contributors

author

Anita Yanna-Schulze

• Department of Cardiology,
  Städtisches Krankenhaus Pirmasens gGmbH, Pettenkoferstr.
  22, 66955 Pirmasens, Germany

author

Günther Schneider

• Medical Faculty of the Saarland University,
  66421 Homburg/Saar, Germany
• Department of Diagnostic and Interventional
  Radiology, Saarland University Hospital, 66421 Homburg/Saar,
  Germany

author

Alexander Maßmann

• Department of Diagnostic and Interventional
  Radiology, Saarland University Hospital, 66421 Homburg/Saar,
  Germany

author

Stefan Gräber

• Department of Medical Biometry, Epidemiology and
  Medical Informatics, Saarland University Hospital, 66421 Homburg/
  Saar, Germany

author

Urban W. Geisthoff

• Department of Otorhinolaryngology, Essen
  University Hospital, 45147 Essen, Germany

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Identifiers

DOI

10.1515/med-2015-0040