肺动静脉畸形影像学诊断

Imaging Diagnosis of Pulonary Arteriovenous Malformation

目的：评价各种成像技术（传统Ｘ线检查、核素显像、ＣＴ、血管造影）诊断ＰＡＶＭ的价值，提高对ＰＡＶＭ的认识。材料和方法：回顾性分析了１２例经手术／血管造影证实ＰＡＶＭ影像学资料。结果：胸部传统Ｘ线检查１２例，８例提示ＰＡＶＭ；肺灌注核素显像６例，均提示胸内右向左分流；ＣＴ检查５例，诊断ＰＡＶＭ３例；血管造影１２例，均确诊为ＰＡＶＭ。结论：临床上除外心脏疾患引起的缺氧症状，胸部Ｘ线检查显示单发或多发结节影，透视大小及形态能改变，存在异常引流血管影者应高度怀疑ＰＡＶＭ。肺灌注核素显像具有筛查作用，ＣＴ扫描对诊断有一定的帮助，血管造影具有确诊价值。

Purpose:To assess the value of all kinds of imaging techniques (including chest X-ray film, scintigraphy, CT and angiography ) and to heighten the awareness of pulmonary arteriovenous malformation Materals and methods:Imaging findings in twelve cases of PAVM proved by operatiopn and/or angiography were analysed retrospectiovely. Results: Twelve cases received chest X-ray film and eight of them were suggested PAVM, all six cases with scintigraphy suggest right-to-left shunt in the chest, five cases in CT showed three PAVM, twelve cases with angiography confirmed the diagnosis of PAVM. Conclusion: Excluding hypoxia caused by heart diseases, we suspect PAVM when single nodule or multiple nodules is present on chest film and the size is changeable in fluroscopy. Scintigraphy may suggest PAVM; CT plays a more important role in PAVM; Angiography is the golden standard for the diagnosis of PAVM.