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Abstract #1200

Contrast-Enhanced Magnetic Resonance Angiography in Management of Pulmonary Arterio-Venous Malformations in Patients with HHT (Osler Disease)

Guenther Schneider1, Arno Buecker1, Alexander Massmann1, Peter Fries1

1Diagnostic and Interventional Radiology, Saarland University Hospital, Homburg, Germany

Purpose of our study was to evaluate CE-MRA for management of pulmonary arterio-venous malformations (PAVM) in patients with hereditary hemorrhagic telangiectasia (HHT). 286 patients (mean-age 45,9 y, male/female = 118/168) with confirmed HHT or first degree relatives underwent screening pulmonary CE-MRA (MultiHance 0.1 mmol/kg bodyweight). Patients with relevant PAVM were referred for DSA. CE-MRA detected 323 PAVM in 97 patients. 74 patients with 263 PAVMs detected on CE-MRA underwent DSA. Significantly fewer PAVMs (205/263 [78%]) were demonstrated on global DSA of which 191 were embolized. Follow-up CE-MRA showed 57 newly developed PAVM in 14 patients (interval 1-6years) and 32 reperfused PAVM in 24 patients (interval 3months-7years). All reperfused PAVMs were confirmed by DSA and reembolized successfully. CE-MRA can be considered method of choice for management of PAVMs in HHT.

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