Carotid ultrasound for pulmonary arteriovenous malformation screening
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...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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De Gruyter
2015-05-01
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| Series: | Open Medicine |
| Subjects: | |
| Online Access: | http://www.degruyter.com/view/j/med.2015.10.issue-1/med-2015-0040/med-2015-0040.xml?format=INT |
| _version_ | 1831650193495293952 |
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| author | Yanna-Schulze Anita Schneider Günther Maßmann Alexander Gräber Stefan Geisthoff Urban W. |
| author_facet | Yanna-Schulze Anita Schneider Günther Maßmann Alexander Gräber Stefan Geisthoff Urban W. |
| author_sort | Yanna-Schulze Anita |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T15:04:41Z |
| format | Article |
| id | doaj.art-48661c7a3536461fafec3989c3c4d42f |
| institution | Directory Open Access Journal |
| issn | 2391-5463 |
| language | English |
| last_indexed | 2024-12-19T15:04:41Z |
| publishDate | 2015-05-01 |
| publisher | De Gruyter |
| record_format | Article |
| series | Open Medicine |
| spelling | doaj.art-48661c7a3536461fafec3989c3c4d42f2022-12-21T20:16:28ZengDe GruyterOpen Medicine2391-54632015-05-0110110.1515/med-2015-0040med-2015-0040Carotid ultrasound for pulmonary arteriovenous malformation screeningYanna-Schulze Anita0Schneider Günther1Maßmann Alexander2Gräber Stefan3Geisthoff Urban W.4Department of Cardiology, Städtisches Krankenhaus Pirmasens gGmbH, Pettenkoferstr. 22, 66955 Pirmasens, GermanyMedical Faculty of the Saarland University, 66421 Homburg/Saar, GermanyDepartment of Diagnostic and Interventional Radiology, Saarland University Hospital, 66421 Homburg/Saar, GermanyDepartment of Medical Biometry, Epidemiology and Medical Informatics, Saarland University Hospital, 66421 Homburg/ Saar, GermanyDepartment of Otorhinolaryngology, Essen University Hospital, 45147 Essen, GermanyObjective: 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.http://www.degruyter.com/view/j/med.2015.10.issue-1/med-2015-0040/med-2015-0040.xml?format=INTHereditary hemorrhagic telangiectasia pulmonary arteriovenous malformation screening contrast-enhanced ultrasound |
| spellingShingle | Yanna-Schulze Anita Schneider Günther Maßmann Alexander Gräber Stefan Geisthoff Urban W. Carotid ultrasound for pulmonary arteriovenous malformation screening Open Medicine Hereditary hemorrhagic telangiectasia pulmonary arteriovenous malformation screening contrast-enhanced ultrasound |
| title | Carotid ultrasound for pulmonary arteriovenous malformation screening |
| title_full | Carotid ultrasound for pulmonary arteriovenous malformation screening |
| title_fullStr | Carotid ultrasound for pulmonary arteriovenous malformation screening |
| title_full_unstemmed | Carotid ultrasound for pulmonary arteriovenous malformation screening |
| title_short | Carotid ultrasound for pulmonary arteriovenous malformation screening |
| title_sort | carotid ultrasound for pulmonary arteriovenous malformation screening |
| topic | Hereditary hemorrhagic telangiectasia pulmonary arteriovenous malformation screening contrast-enhanced ultrasound |
| url | http://www.degruyter.com/view/j/med.2015.10.issue-1/med-2015-0040/med-2015-0040.xml?format=INT |
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