Chest ❯ PAVM
CT Protocol for PAVM
| Problem | The presence of a PAVM (pulmonary AV Malformation) |
| Protocol | The study is done as an arterial phase acquisition with a scan delay of 30 seconds and an injection rate of 5cc/sec for 100 ccc total volume. The image s are reconstructed with thin section CT (.75mm) and narrow increments (.5 mm). The images are reviewed in axial. multiplanar and 3D reconstructions. The MIP imaging with thin slabs is especially valuable for detection of small PAVMs. |
| Pearls | 1. The detection of PAVMs may be part of a hemoptysis workup or part of the evaluation of a patient with HHT disease (Hereditary hemorrhagic telangiectasia (HHT). HHT is also known as Osler–Weber–Rendu syndrome or Osler–Weber–Rendu disease. 2. The PAVMs in HHT disease are often small and multiple and can easily be missed on routine axial CT. We find that MIP imaging using axial, coronal and sagittal plane is helpful in detection of usmall PAVMs. The feeding and draining vessels are usually well defined 3. Treatment of PAVMs is usually embolization and CT is good for following these patients to look for new PAVMs as well. 4. In patients with large PAVMs sometimes venous phase imaging may also be helpful for defining the feeding and draining vessels. |