Highlights
- •Pulmonary venous anomalies are vascular mimics of pulmonary arteriovenous malformations that may lead to misdiagnosis.
- •Anomalous unilateral single pulmonary vein and meandering vein have clinical and imaging characteristics different from.
- •Optimal CT technique and careful review of CT scans are necessary to minimize inappropriate invasive pulmonary angiography.
Abstract
Purpose
To investigate pulmonary venous anomaly as a cause of pulmonary arteriovenous malformation
(PAVM) misdiagnosis.
Materials and methods
We reviewed adult patients within a 7.5-year period with CT scans initially diagnosed
with PAVM and subsequent conventional pulmonary angiograms.
Results
Pulmonary arteriography showed no PAVM on arterial phase for 10 out of 99 patients,
comprising the misdiagnosed group. Four misdiagnosed patients had pulmonary venous
anomalies and six had nodular lesions on CT.
Conclusion
Pulmonary venous anomalies are vascular mimics of PAVMs that may lead to misdiagnosis.
Optimal CT technique and careful imaging review are necessary to minimize inappropriate
invasive angiography.
Keywords
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References
- Imaging of hereditary hemorrhagic telangiectasia.AJR Am J Roentgenol. 2004; 183: 307-314
- Primary determinants of ischaemic stroke/brain abscess risks are independent of severity of pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia.Thorax. 2008; 63: 259-266
- Pulmonary arteriovenous malformations: effect of embolization on right-to-left shunt, hypoxemia, and exercise tolerance in 66 patients.AJR Am J Roentgenol. 2002; 179: 347-355
- Digital subtraction pulmonary arteriography versus multidetector CT in the detection of pulmonary arteriovenous malformations.J Vasc Interv Radiol. 2008; 19: 1582-1588
- International guidelines for the diagnosis and management of hereditary haemorrhagic telangiectasia.J Med Genet. 2011; 48: 73-87
- Pulmonary arteriovenous malformations and their mimics.Clin Radiol. 2015; 70: 96-110
- Learning from the pulmonary veins.Radiographics. 2013; 33: 999-1022
- Meandering pulmonary veins mimicking arteriovenous malformation.J Cardiovasc Comput Tomogr. 2015; 9: 149-150
- Anomalous unilateral single pulmonary vein mimicking pulmonary nodules on HRCT of the lungs and scimitar syndrome on chest radiograph: multidetector CT findings.J Thorac Imaging. 2009; 24: 142-146
- Diagnostic criteria for hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome).Am J Med Genet. 2000; 91: 66-67
- Anomalous unilateral single pulmonary vein: two cases mimicking arteriovenous malformations and a review of the literature.Australas Radiol. 2005; 49: 246-251
- MDCT of anomalous unilateral single pulmonary vein.AJR Am J Roentgenol. 2004; 183: 1241-1243
- Anomalous unilateral single pulmonary vein masquerading as a pulmonary arteriovenous malformation.AJR Am J Roentgenol. 2001; 176: 1333
- Anomalous lobar pulmonary vein resembling pulmonary arteriovenous malformation.J Thorac Imaging. 2012; 27: W111-4
- Incidental meandering right pulmonary vein, literature review and proposed nomenclature revision.World J Radiol. 2013; 5: 215-219
- Anomalous unilateral single pulmonary vein versus scimitar syndrome: comparison of two paediatric cases and a review of the literature.J Med Imaging Radiat Oncol. 2012; 56: 247-254
- Anomalous unilateral single pulmonary vein: multidetector CT findings.AJR Am J Roentgenol. 2000; 175: 1464-1465
- Pulmonary arteriovenous malformations: evaluation with CT of the chest before and after treatment.Radiology. 1992; 182: 809-816
Article info
Publication history
Published online: September 08, 2017
Accepted:
September 6,
2017
Received in revised form:
August 9,
2017
Received:
May 9,
2017
Footnotes
☆Conflict of interest: None to disclose.
☆☆Source of funding: None to disclose.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.