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ORIGINAL RESEARCHPULMONARY VASCULAR DISEASEContrast Echocardiography Grading Predicts Pulmonary Arteriovenous Malformations on CT
Section snippets
Materials and Methods
A retrospective review of charts, TTCE, and imaging was conducted. One hundred fifty-five consecutive newly referred patients to the Toronto HHT Center (adult clinic) were screened with TTCE between June 2002 and September 2004. All patients with positive TTCE results were included in this study and underwent thoracic CT scanning. This was the routine screening protocol followed for all patients referred to the HHT Center from 2002 to 2004. For each patient, the TTCE was reviewed for the
Results
Of 155 patients screened with TTCE, 104 patients (67%) had positive TTCE results. Mean patient age was 45 years (range, 16 to 75 years). The majority of patients screened were female (62%).
Of 104 patients with positive TTCE results, we had complete data for 90 patients (87%). In 14 patients, data were incomplete because the echocardiography tapes were lost and the studies could not be reviewed. Twenty-four of the 90 patients (27%) for whom we had both TTCE and CT data had CT detectable PAVMs.
Discussion
Patients with PAVMs are at significantly increased risk of complications including stroke, cerebral abscess, and massive pulmonary hemorrhage.3410 Early diagnosis of PAVMs is important so that preventative treatment with embolotherapy may be performed.3410 TTCE has been recommended as the screening test of choice for PAVMs, although the intensity of shunting on TTCE remains of uncertain clinical significance. We demonstrate here that TTCE shunt grading predicts the probability of PAVMs on CT.
Conclusions
We have demonstrated that TTCE shunt grading, on a four-point scale, is significantly associated with the probability of detecting PAVMs on CT. This provides additional information that is clinically relevant in guiding decision making about further diagnostic testing.
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Cited by (0)
Financial support (M.E.F) was provided by the Nelson Arthur Hyland Foundation, St. Michael's Hospital Research Institute.
This study was conducted at St. Michael's Hospital.
The authors have no conflicts of interest to disclose.