Contrast-Enhanced Magnetic Resonance Angiography (CE-MRA) for Detection of Reperfused Pulmonary Arteriovenous Malformations (PAVM) After Coil Embolization in Patients with Hereditary Hemorrhagic Telangiectasia (HHT)

Guenther Schneider¹, Alexander Massmann², Peter Fries², Marcus Katoh², Urban Geisthoff³, Arno Buecker²

Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber disease, is an autosomal-dominant inherited vascular disorder associated with mucocutaneous, pulmonary, cerebral and visceral arteriovenous malformations (AVM). Pulmonary arteriovenous shunts (PAVM) are associated with high morbidity and mortality. The primary choice of treatment of PAVMs is catheter embolization with platinum coils, which is technically safe and effective. However, even in an initial successful occlusion, there may be a reperfusion of embolized feeding vessels or opening of collateral vessels. This study shows that contrast-enhanced magnetic resonance angiography (CE-MRA) is a useful tool for follow-up examinations of treated PAVMs, in which platinum coils were used for embolization, preferable to CT and even global pulmonary catheter angiography.